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In addition to documenting the previously listed clinical information on the Prior Authorization Drug Attachment for Xyrem and Xywav form, medical records must be submitted with the PA request to support the member's medical condition of idiopathic hypersomnia

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For instance, if the concentration is 1 mg per 10 units, the calculation for 50 units would be: 50 units 10 units/mg = 5 mg