Cigna + Oscar
Lupron Depot (3-Month) (leuprolide (3 month))
Hormones : Drugs for Women
  • Hemophilia A (Factor VIII):
    Duration: 6 Month(s)
    Specialist Required: Yes
    Documented Diagnosis: Yes
    Medical Test Required: No
    Specialist Type(s): Hematologist
    Reauthorization Required: Yes
    Duration of Reauthorization: = 6 month(s)
    Dosing Limit(s): Unspecified
    Diagnosis Type(s): Unspecified
    Diagnosis Treatments: Routine propylaxis
    Treatment Center Required: No

    Hemophilia A or B with Inhibitor:
    Duration: 6 Month(s)
    Specialist Required: Yes
    Documented Diagnosis: Yes
    Medical Test Required: No
    Specialist Type(s): Hematologist
    Reauthorization Required: Yes
    Duration of Reauthorization: = 6 month(s)
    Dosing Limit(s): <= 3
    Diagnosis Type(s): Unspecified
    Diagnosis Treatments: 1 of Bleeding episodes;Routine propylaxis
    Treatment Center Required: No
    Dosing Limits Exist: No

  • PA Required
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