| Anthem Blue Cross (HMO, PPO, EPO) |
| Lenvima (18 MG Daily Dose) (lenvatinib) |
| Drugs for Cancer : Drugs for Cancer |
- Prior Authorization: Nasal Polyposis:
Documented Diagnosis: Yes
Duration: 12 Month(s)
Reauthorization Required: Yes
- Step Therapy: ST Required
- Quantity Limit: limit maximum 120 ML PER 30 day(s)
- Split Fill;
- Prior Authorization: Pulmonary Arterial Hypertension:
Duration: 12 Month(s)
- Step Therapy: ST_APPLIES
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