- Quantity Limit: limit maximum 180 EA PER 30 day(s)
- Oral anti-cancer drug.
- Lambert-Eaton Myasthenic Syndrome (LEMS):
Duration: 3 Month(s)
Documented Diagnosis: Yes
Medical Test Required: Yes
Specialty Pharmacy Provider(s): 1 of Accredo Health Group, Inc.;Apothecary By Design;Circle Care;The Pharmacy at Maine Medical Center
Reauthorization Required: No
Duration of Reauthorization: N/A
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