Anthem Blue Cross (HMO, PPO, EPO)
Gemtesa (vibegron)
Drugs for the Urinary System : Drugs for the Bladder
  • Overactive Bladder:
    Duration: 1 year(s)
    Documented Diagnosis: Yes
    Medical Test Required: No
    Reauthorization Required: No
    Duration of Reauthorization: N/A

  • Quantity Limit: 1 tablet per 1 day(s).
  • Split Fill;
  • Prior Authorization: Overactive Bladder:
    Documented Diagnosis: Yes
    Duration: 1 year(s)

  • Step Therapy: Overactive Bladder:
    ST Multiple Generics

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