- Quantity Limit: limit maximum 2 EA PER 1 day(s)
- Breast Cancer: HR+ (HER2-):
Age Requirement: <= 19
Duration: 12 Month(s)
- Orally administered anticancer medication.
- Prior Authorization: Breast Cancer: HR+ (HER2-):
Age Requirement: <= 19
Duration: 12 Month(s)
|