| Anthem Blue Cross (HMO, PPO, EPO) |
| Lenvima (8 MG Daily Dose) (lenvatinib) |
| Drugs for Cancer : Drugs for Cancer |
- Quantity Limit: limit maximum 6 EA PER fill retail
- Prior Authorization: PA Required
- Prior Authorization: Pain Narcotic: Opioid:
Documented Diagnosis: Yes
Duration: 12 Month(s)
Reauthorization Required: Yes
- Prior Authorization: PA Required
- Available only through Specialty Pharmacy;
- Step Therapy: ST_APPLIES
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