Anthem Blue Cross - 2014 to Present (HMO, PPO, EPO)
Zevalin Y-90 (kit for yttrium-90-ibritumomab)
Drugs for Cancer : Drugs for Cancer
  • PA_APPLIES
  • Neuromyelitis Optica Spectrum Disorder:
    Duration: 1 year(s)
    Documented Diagnosis: Yes
    Medical Test Required: No
    Specialty Pharmacy Provider(s): Preferred Limited Distribution Network
    Reauthorization Required: No
    Duration of Reauthorization: N/A