Sutter Health Plus
Kisqali (600 MG Dose) (ribociclib)
Drugs for Cancer : Drugs for Cancer
  • PA Applies
  • Pain Narcotic: Opioid:
    Duration: 24 Month(s)
    Documented Diagnosis: Yes
    Medical Test Required: No
    Reauthorization Required: Yes
    Duration of Reauthorization: = 6 month(s)
    Diagnosis Type(s): 2 of Chronic Pain;Moderate to Severe Pain
    Used for Cancer Patients: Yes
    Around-The-Clock Analgesic Required: Yes
    Morphine Equivalent Dose (MED) Limit: N/A
    Morphine Equivalent Dose (MED) Required: No

  • PA Applies
  • Quantity Limit: 6 tablets per 1 day(s).
<< Return | Back to top