DraftFirst-level appealStep therapy denial · R. Davis
The plan denied this request on 02-OCT-2026, stating that step therapy was not met.Payer stated
The patient took adalimumab from 14-MAR-2025 to 09-SEP-2025 and stopped for an inadequate response.Practice confirmed
Why MedMojo™ wrote thisPractice confirmedEntered by Ellen from the progress note of 09-SEP-2025
The patient took etanercept from 20-SEP-2025 to 30-MAY-2026 and stopped because it was not tolerated.Practice confirmed
The plan's notice requires an inadequate response to two TNF inhibitors.Payer stated
This therapy is clearly the best option for this patient.Removed: a judgment, not in the record