| Kaiser Foundation Health Plan Northern California - All plan years |
| Kogenate FS (antihemophil FVIII,full length) |
| Drugs for the Blood : Drugs to Prevent Bleeding |
- PA Applies
- Prior Authorization: NSCLC ALK+ OR ROS1+ Disease:
Documented Diagnosis: Yes
Medical Test Required: Yes
Age Requirement: < 19
Duration: 12 Month(s)
Reauthorization Required: Yes
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