| Anthem Blue Cross (HMO, PPO, EPO) |
| Balversa (erdafitinib) |
| Drugs for Cancer : Drugs for Cancer |
- Prior Authorization: Diabetic Medical Supplies:
Documented Diagnosis: Yes
Duration: 1 plan year
Reauthorization Required: Yes
- Quantity Limit: limit maximum 30 EA PER 30 day(s)
- Quantity Limit: 30 tabs / 30 days
- PA_APPLIES
|