| UnitedHealthcare - 2014 to Present |
| Kanjinti (Intravenous Solr) (Trastuzumab-Pkrb) |
| Drugs for Cancer : Drugs for Cancer |
- Prior Authorization: Peanut Allergy:
Documented Diagnosis: Yes
Medical Test Required: Yes
Age Requirement: >= 4
Duration: 6 Month(s)
Reauthorization Required: Yes
- QL (30 per Rx);
|