generic fluoxetine immediate-release tablets — Medica
major depressive disorder
Preferred products
- generic bupropion extended-release tablets
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Initial criteria
- Patient is an adult (age > 18 years)
- Patient has a history of use of one Step 1 Product (Standard Criteria) OR two Step 1 Products (High Impact Criteria) within the 130-day look-back period
Reauthorization criteria
- Same as initial criteria
Approval duration
1 year