Health Net
Ogivri (trastuzumab-dkst)
Drugs for Cancer : Drugs for Cancer
  • Prior Authorization: Anemia:
    Documented Diagnosis: Yes
    Medical Test Required: Yes
    Duration: 3 Month(s)
    Reauthorization Required: Yes

  • Diabetes Type 2: Short Acting Insulin (Meal-time):
    Duration: 1 year(s)
    Documented Diagnosis: Yes
    Medical Test Required: No
    Reauthorization Required: No
    Duration of Reauthorization: N/A