| Kaiser Foundation Health Plan Northern California |
| Depo-Provera (medroxyprogesterone) |
| Drugs for Cancer : Drugs for Cancer |
- Prior Authorization: Breast Cancer: HR+ (HER2+), Endometrial Cancer:
Documented Diagnosis: Yes
Medical Test Required: Yes
Age Requirement: >= 18
Duration: 6 Month(s)
Reauthorization Required: Yes
Gastric Cancer:
Age Requirement: >= 18
Duration: 6 Month(s)
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