| UnitedHealthcare |
| Kisqali (400 MG Dose) (ribociclib) |
| Drugs for Cancer : Drugs for Cancer |
- Quantity Limit: 10 capsules per 1 fill(s).
- User Field 13;
- Prior Authorization: Hemophilia A (Factor VIII):
Documented Diagnosis: Yes
Duration: 6 Month(s)
Reauthorization Required: Yes
- Step Therapy: ST_APPLIES
- Prior Authorization: PA_APPLIES
|