| Anthem Blue Cross (HMO, PPO, EPO) |
| Vectibix 200 Mg/10 Ml (20 Mg/Ml) Soln (panitumumab) |
| Drugs for Cancer : Drugs for Cancer |
- Colorectal Cancer:
Duration: 1 year(s)
Documented Diagnosis Requirement: Inferred from Available Documentation
Medical Test Required: Yes
Reauthorization Required: No
Duration of Reauthorization: N/A
Drug Policy Based On: NCCN Guidelines
Documented Diagnosis: Yes
Specialty Pharmacy is Required: Not Defined
- Prior Authorization: Colorectal Cancer:
Documented Diagnosis: Yes
Medical Test Required: Yes
Duration: 1 year(s)
|