| Kaiser Foundation Health Plan Southern California |
| tretinoin (antineoplastic) (tretinoin (antineoplastic)) |
| Drugs for Cancer : Drugs for Cancer |
- Quantity Limit: limit maximum 80 mL PER 1 day(s)
- NSCLC EGFR Mutated:
Duration: 1 year(s)
Documented Diagnosis: Yes
Medical Test Required: No
Reauthorization Required: No
Duration of Reauthorization: N/A
|