| Anthem Blue Cross (HMO, PPO, EPO) |
| Duavee (conj estrogens-bazedoxifene) |
| Hormones : Drugs for Women |
- Quantity Limit: 1 tablet per 1 day(s).
- Prior Authorization: Vasomotor Symptoms Associated with Menopause (VMS):
Documented Diagnosis: Yes
Age Requirement: >= 18
Duration: 1 year(s)
- Vasomotor Symptoms Associated with Menopause (VMS):
Age Requirement: >= 18
Duration: 1 year(s)
Documented Diagnosis: Yes
Medical Test Required: No
Reauthorization Required: No
Duration of Reauthorization: N/A
For FAX form click HERE
Our electronic prior authorization (ePA) process is the preferred method for submitting pharmacy prior authorization requests. Creating an account is free, easy and helps patients get their medications sooner. You can complete the process through your current electronic health record/electronic medical record (EHR/EMR) system or by using one of these ePA sites:
Log in to Surescripts
Log in to CoverMyMeds; For details on drug coverage click HERE;- PA Applies
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