Ztalmy GANAXOLONE CDKL5 Deficiency Disorder User Guide
STANDARD COMMERCIAL DRUG FORMULARY PRIOR AUTHORIZATION GUIDELINES GANAXOLONE Generic Brand HICL GCN Medi-Span Exception/Other GANAXOLONE ZTALMY 47912 GPI-10 (7260003300) GUIDELINES FOR USE 1. Does the patient have a diagnosis of seizures and meet ALL of the following criteria? The patient…