Erectile Dysfunction Agents - Prior Authorization and Notification ...
b. Patient is not concurrently receiving an alternative phosphodiesterase-5 enzyme inhibitor (e.g. Cialis, Levitra, Staxyn, Stendra, or Viagra). -AND- c. History of trial/failure, contraindication or intolerance to vardenafil (generic Levitra) 3. Viagra will be approved based on all of the following criteria: a. Patient has an organic cause of ... ................
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