| Anthem Blue Cross - 2014 to Present (HMO, PPO, EPO) |
| Kisqali (400 MG Dose) (ribociclib) |
| Drugs for Cancer : Drugs for Cancer |
- Step Therapy: ST_APPLIES
- PA_APPLIES
- Quantity Limit: 30 syringes per 30 day(s).
- Hemophilia A (Factor VIII):
Duration: 12 Month(s)
Documented Diagnosis: Yes
Medical Test Required: No
Reauthorization Required: Yes
Duration of Reauthorization: = 1 plan year
Dosing Limit(s): N/A
Treatment Center Required: No
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