- Preventive health - zero copay may apply.
- Quantity Limit: 9 tablets per 30 day(s).
- Quantity Limit: 15 g per prescription
- Quantity Limit: 800 tablets per 30 day(s).
- Metastatic Prostate Cancer:
Age Requirement: >= 18
Duration: 1 year(s)
Documented Diagnosis: Yes
Medical Test Required: No
Specialty Pharmacy Provider(s): 1 of Accredo Health Group, Inc.;Apothecary By Design;Circle Care;The Pharmacy at Maine Medical Center
Reauthorization Required: No
Duration of Reauthorization: N/A
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