| Anthem Blue Cross (HMO, PPO, EPO) |
| Brovana (arformoterol) |
| Drugs for the Lungs : Drugs for Asthma/COPD |
- Step Therapy Applies
- Quantity Limit: 60 vial per 30 day(s).
- COPD (oral):
Duration: 1 year(s)
Medical Test Required: No
Reauthorization Required: No
Duration of Reauthorization: N/A
COPD associated with chronic bronchitis: No
History of COPD exacerbation: No
Documented Diagnosis: No
- Prior Authorization: COPD (oral):
Duration: 1 year(s)
Medical Test Required: No
Reauthorization Required: No
Duration of Reauthorization: N/A
COPD associated with chronic bronchitis: No
History of COPD exacerbation: No
Documented Diagnosis: No
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