Western Health Advantage
Adlyxin Starter Pack (lixisenatide)
Hormones : Drugs for Diabetes
  • 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

  • Quantity Limit: limit maximum 900 ML PER 30 day(s)
  • Quantity Limit: 200 syringes per 30 day(s).