Anthem Blue Cross (HMO, PPO, EPO) |
Evenity (romosozumab-aqqg) |
Hormones : Drugs for Menopause and Bone Loss |
- Quantity Limit: 30 day supply per 1 fill(s).
- Prior Authorization: Low Testosterone:
PA Applies
- Prior Authorization: Immune Thrombocytopenic Purpura (ITP):
Documented Diagnosis: Yes
Age Requirement: >= 18
Duration: 12 Month(s)
Reauthorization Required: Yes
- PA Applies
For FAX form click HERE Our electronic prior authorization (ePA) process is the preferred method for submitting pharmacy prior authorization requests. Creating an account is free, easy and helps patients get their medications sooner. You can complete the process through your current electronic health record/electronic medical record (EHR/EMR) system or by using one of these ePA sites: Log in to Surescripts Log in to CoverMyMeds; For details on drug coverage click HERE;
- Quantity Limit: 1 capsule per 1 day(s).
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