Health Net
HumaLOG Mix 75/25 KwikPen (insulin lispro protamin-lispro)
Hormones : Drugs for Diabetes
  • Prior Authorization: Cervical Cancer, Colorectal Cancer, Diabetic Retinopathy, Endometrial Cancer, Macular Edema, Macular Edema Following Retinal Vein Occlusion (RVO), Malignant Pleural Mesothelioma, Neovascular (Wet) Age-Related Macular Degeneration (AMD), NSCLC Systemic Therapy, Ovarian Cancer, Recurrent Glioblastoma:
    Documented Diagnosis: Yes
    Duration: 1 year(s)

    Kidney Cancer:
    Documented Diagnosis: Yes
    Medical Test Required: Yes
    Duration: 1 year(s)

<< Return | Back to top