Xenazine≥nericName=tetrabenazine∨gName=HealthNet - All plan years ()
Drugs for the Nervous System⊂class=Drugs for the Nervous System : 
  • Prior Authorization: Anemia due to Chemotherapy:
    Documented Diagnosis: Yes
    Duration: 8 week(s)
    Reauthorization Required: Yes

    Anemia due to Chronic Kidney Disease:
    Documented Diagnosis: Yes
    Duration: 2 Month(s)
    Reauthorization Required: Yes

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