Anthem Blue Cross (HMO, PPO, EPO) |
Trelstar 11.25 Mg/2 Ml Syrg (triptorelin pamoate) |
Drugs for Cancer : Drugs for Cancer |
- Documented Diagnosis: Yes
Medical Test Required: No
Reauthorization Required: No
Duration of Reauthorization: N/A
- Prior Authorization: Documented Diagnosis: Yes
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