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Get Coventry Health Care CHCH 2033-1 2009-2024

R uses are not covered. Documented failure* of the following: 1. ONE of the tricyclic antidepressants (TCA), AND 2. ONE of the muscle relaxants (e.g. ), AND 3. Documented non-pharmacologic therapies (cognitive behavioral therapies, exercise etc.), AND 4. At least TWO drugs from the following agents: a. Any one SSRI, or b. , or c. *Failure is defined as intolerance or no clinical efficacy. NON-covered uses are listed in the Prior Authorization criteria, which is.

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