- Step Therapy Applies
- Prior Authorization: Chronic Lymphocytic Leukemia:
Documented Diagnosis: Yes
Duration: 12 Month(s)
- Chronic Lymphocytic Leukemia:
Duration: 12 Month(s)
Documented Diagnosis: Yes
Medical Test Required: No
Reauthorization Required: No
Duration of Reauthorization: N/A
Drug Policy Based On: NCCN Guidelines
Diagnosis Types: Medically accepted uses supported by NCCN Category 1, 2A or 2B level of evidence
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