Western Health Advantage - All plan years |
Kisqali Femara(200 MG Dose) (ribociclib-letrozole) |
Drugs for Cancer : Drugs for Cancer |
- Step Therapy: ST_APPLIES
- Quantity Limit: limit maximum 30 EA PER 30 day(s)
- Prior Authorization: Diabetic Medical Supplies:
Duration: 1 year(s)
- Prior Authorization: PA Required
|