Anthem Blue Cross - 2014 to Present (HMO, PPO, EPO)
Kovaltry (
antihemophil FVIII,full length
)
Drugs for the Blood : Drugs to Prevent Bleeding
Prior Authorization: PA_APPLIES
Quantity Limit: limit maximum 30 day(s) supply
Quantity Limit: 4 tablets per 1 day(s).
PA Required
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