Anthem Blue Cross (HMO, PPO, EPO)
Lenvima (12 MG Daily Dose) (lenvatinib)
Drugs for Cancer : Drugs for Cancer
  • Prior Authorization: Documented Diagnosis: Yes
    Duration: 6 Month(s)
    Reauthorization Required: Yes

  • Step Therapy: Ulcerative Colitis (UC):
    ST Multiple Brands

  • Step Therapy: Ulcerative Colitis (UC):
    ST Single Generic

  • Prior Authorization: PA Applies
  • Prior Authorization: Myelodysplastic Syndrome:
    Documented Diagnosis: Yes
    Age Requirement: >= 18
    Duration: 6 Month(s)
    Reauthorization Required: Yes

  • Quantity Limit: 8 tablets per 1 day(s).
<< Return | Back to top