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