Anthem Blue Cross (HMO, PPO, EPO) |
Firmagon 80 Mg Solr (degarelix) |
Drugs for Cancer : Drugs for Cancer |
- Prior Authorization: Documented Diagnosis: Yes
- Metastatic Prostate Cancer:
Documented Diagnosis: Yes
Medical Test Required: No
Specialty Pharmacy Provider(s): 1 of Accredo Health Group, Inc.;Apothecary By Design;Circle Care;The Pharmacy at Maine Medical Center
Reauthorization Required: No
Duration of Reauthorization: N/A
Non-Metastatic Prostate Cancer: Documented Diagnosis: Yes
Medical Test Required: No
Reauthorization Required: No
Duration of Reauthorization: N/A
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