| Anthem Blue Cross (HMO, PPO, EPO) |
| fulvestrant (fulvestrant) |
| Drugs for Cancer : Drugs for Cancer |
- Prior Authorization: Obesity due to Pathogenic Variants:
Documented Diagnosis: Yes
Medical Test Required: Yes
Age Requirement: >= 6
Duration: 16 week(s)
Reauthorization Required: Yes
- Prior Authorization: Colorectal Cancer, Esophageal Cancer, NSCLC EGFR Mutated, NSCLC Systemic Therapy:
Documented Diagnosis: Yes
Age Requirement: >= 18
Duration: 6 Month(s)
Reauthorization Required: Yes
Gastric Cancer:
Age Requirement: >= 18
Duration: 6 Month(s)
Hepatocellular Carcinoma:
Documented Diagnosis: Yes
Medical Test Required: Yes
Age Requirement: >= 18
Duration: 6 Month(s)
- Insomnia:
Duration: 1 year(s)
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