| Anthem Blue Cross (HMO, PPO, EPO) |
| Cometriq (60 MG Daily Dose) (cabozantinib) |
| Drugs for Cancer : Drugs for Cancer |
- QL (19 per Rx);
- PA_APPLIES
- Prior Authorization: Peanut Allergy:
Documented Diagnosis: Yes
Medical Test Required: Yes
Age Requirement: >= 4
Duration: 6 Month(s)
Reauthorization Required: Yes
- Prior Authorization: Pulmonary Arterial Hypertension:
Duration: 12 Month(s)
|