| Anthem Blue Cross (HMO, PPO, EPO) |
| Symtuza (darunavir-cobi-emtri-tenof ala) |
| Drugs for Infections : Drugs for Viral Infections |
- Quantity Limit: 4 capsules per 1 day(s).
- Quantity Limit: 1 capsule per 1 day(s).
- Quantity Limit: limit maximum 150 EA PER 30 day(s)
- Prior Authorization: PA_APPLIES
- Step Therapy: Diabetic Medical Supplies:
ST Multiple Brands
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