- Oral anti-cancer drug. Preventive health - zero copay may apply.
- Hemophilia B (Factor IX):
Duration: 1 year(s)
Documented Diagnosis: No
Reauthorization Required: No
Duration of Reauthorization: N/A
Dosing Limit(s): N/A
Treatment Center Required: No
- Prior Authorization: PA_APPLIES
- Available only through Specialty Pharmacy;
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