| Anthem Blue Cross (HMO, PPO, EPO) |
| Bydureon BCise (exenatide microspheres) |
| Hormones : Drugs for Diabetes |
- Quantity Limit: limit maximum 30 day(s) supply
- Step Therapy: Myasthenia Gravis:
ST Multiple Generics
Rheumatoid Arthritis (RA):
ST Generic and Brand
- Prior Authorization: PA_APPLIES
- Quantity Limit: 204 lancets per 30 day(s).
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