| Anthem Blue Cross (HMO, PPO, EPO) |
| Blenrep (belantamab mafodotin-blmf) |
| Drugs for Cancer : Drugs for Cancer |
- PA Required
- Anti-Cancer:Maximum $200 copayment per State Law. Must use AcariaHealth Specialty Rx.
- Quantity Limit: 204 lancets per 30 day(s).
- QL (30 per Rx);
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