| Kaiser Foundation Health Plan Southern California |
| dextrose 70 % in water (D70W) (dextrose 70 % in water (D70W)) |
| Drugs for Nutrition : Drugs for Nutrition |
- Metastatic Prostate Cancer:
Duration: 12 Month(s)
Documented Diagnosis: Yes
Medical Test Required: Yes
Reauthorization Required: Yes
Duration of Reauthorization: = 12 month(s)
Non-Metastatic Prostate Cancer:
Duration: 12 Month(s)
Documented Diagnosis: Yes
Medical Test Required: No
Reauthorization Required: Yes
Duration of Reauthorization: = 12 month(s)
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