Cigna + Oscar
Pulmozyme (dornase alfa)
Drugs for the Lungs : Drugs for the Lungs
  • Prior Authorization: Pulmonary Arterial Hypertension:
    Duration: 12 Month(s)

  • Neutropenia:
    Duration: 1 year(s)
    Medical Test Required: No
    Reauthorization Required: No
    Duration of Reauthorization: N/A
    Risk Factor for Developing Febrile Neutropenia (FN): 1 of Active tissue infection(s);Age greater than 65 years;Bone marrow involvement;Liver dysfunction;Poor performance status;Poor renal function;Previous episodes of febrile neutropenia/ infection
    Documented Diagnosis: Yes
    Criteria includes risk factor for developing FN: Yes

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