| Anthem Blue Cross (HMO, PPO, EPO) |
| Aldurazyme (laronidase) |
| Drugs for Metabolic Disease : Drugs for Metabolic Disease |
- Quantity Limit: 204 lancets per 30 day(s).
- Prior Authorization: PA Required
- Prior Authorization: MAC Lung Disease:
Documented Diagnosis: Yes
Medical Test Required: Yes
Age Requirement: >= 18
Duration: 6 Month(s)
Reauthorization Required: Yes
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