| Anthem Blue Cross - 2014 to Present (HMO, PPO, EPO) |
| Zytiga (abiraterone) |
| Drugs for Cancer : Drugs for Cancer |
- Step Therapy: ST_APPLIES
- Duchenne Muscular Dystrophy (DMD):
Age Requirement: <= 15
Duration: 6 Month(s)
Specialist Required: Yes
Documented Diagnosis: Yes
Medical Test Required: Yes
Specialist Type(s): Neurologist
Reauthorization Required: Yes
Duration of Reauthorization: = 6 month(s)
Specialty Pharmacy is Required: Not Defined
- 1;
- Quantity Limit: limit maximum 30 EA PER 30 day(s)
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