Anthem Blue Cross (HMO, PPO, EPO)
Lyumjev (insulin lispro-aabc)
Hormones : Drugs for Diabetes
  • Prior Authorization: Endometriosis:
    Documented Diagnosis: Yes
    Duration: 6 Month(s)
    Reauthorization Required: Yes

  • Quantity Limit: 30 day supply per 1 fill(s).
  • Step Therapy: ST_APPLIES
  • Quantity Limit: limit maximum 1 EA PER 1 day(s)