Anthem Blue Cross (HMO, PPO, EPO) |
Elestrin (estradiol) |
Hormones : Drugs for Women |
- Quantity Limit: 1 pump per 30 day(s).
- Step Therapy: Vasomotor Symptoms Associated with Menopause (VMS):
ST Multiple Generics
- Vasomotor Symptoms Associated with Menopause (VMS):
Duration: 1 year(s)
Documented Diagnosis: No
Medical Test Required: No
Reauthorization Required: No
Duration of Reauthorization: N/A
- Prior Authorization: Vasomotor Symptoms Associated with Menopause (VMS):
Duration: 1 year(s)
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