Anthem Blue Cross (HMO, PPO, EPO)
Follistim AQ (follitropin beta)
Hormones : Drugs for Women
  • Quantity Limit: 30 day supply per 1 fill(s).
  • Step Therapy: ST_APPLIES
  • Step Therapy: Cystic Fibrosis (CF):
    ST Single Generic

  • 1; User Field 13;
  • PA_APPLIES
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