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Prior Authorization Criteria - Viltepso (Viltolarsen) - Mississippi
Prior Authorization Criteria - Viltepso (Viltolarsen) is a legal document that was released by the Mississippi Division of Medicaid - a government authority operating within Mississippi.
FAQ
Q: What is Viltepso?
A: Viltepso is a medication used to treat a specific type of Duchenne muscular dystrophy in patients with particular genetic mutations.
Q: What is Duchenne muscular dystrophy?
A: Duchenne muscular dystrophy is a genetic disorder that causes progressive muscle weakness and degeneration.
Q: Who is Viltepso intended for?
A: Viltepso is intended for patients with Duchenne muscular dystrophy who have a confirmed mutation of the DMD gene that is amenable to exon 53 skipping.
Q: What are the criteria for prior authorization for Viltepso in Mississippi?
A: Specific criteria for prior authorization for Viltepso in Mississippi may vary. It is recommended to consult with the insurance provider or healthcare professional for accurate and up-to-date information.
Form Details:
- Released on January 20, 2021;
- The latest edition currently provided by the Mississippi Division of Medicaid;
- Ready to use and print;
- Easy to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Mississippi Division of Medicaid.
Download Prior Authorization Criteria - Viltepso (Viltolarsen) - Mississippi
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