| Western Health Advantage |
| chorionic gonadotropin, human (chorionic gonadotropin, human) |
| Hormones : Drugs for Women |
- Derm: Acne Vulgaris:
Documented Diagnosis: Yes
Medical Test Required: No
Reauthorization Required: Yes
Duration of Reauthorization: Unspecified
Limited to non-cosmetic use: No
- ST_APPLIES
- Chronic Lymphocytic Leukemia:
Duration: 1 year(s)
Documented Diagnosis: Yes
Medical Test Required: No
Reauthorization Required: No
Duration of Reauthorization: N/A
Drug Policy Based On: Payer Specific
Diagnosis Types: 1 of Chronic Lymphocytic Leukemia;Small Lymphocytic Lymphoma
|