Anthem Blue Cross - 2014 to Present (HMO, PPO, EPO) |
Qbrexza (glycopyrronium tosylate) |
Drugs for the Skin : Drugs for the Skin |
- PA Applies
- PA Applies
- Sickle Cell Disease:
Age Requirement: >= 5
Duration: 1 plan year
Documented Diagnosis: Yes
Medical Test Required: No
Reauthorization Required: Yes
Duration of Reauthorization: = 1 plan year
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