Anthem Blue Cross (HMO, PPO, EPO)
Lenvima (24 MG Daily Dose) (lenvatinib)
Drugs for Cancer : Drugs for Cancer
  • ST_APPLIES
  • Quantity Limit: 204 lancets per 30 day(s).
  • Quantity Limit: limit maximum 90 EA PER 30 day(s)
  • Assisted Reproductive Technology (ART):
    Duration: 1 year(s)
    Documented Diagnosis: Yes
    Medical Test Required: No
    Specialty Pharmacy Provider(s): Accredo Health Group, Inc.
    Reauthorization Required: No
    Duration of Reauthorization: N/A

  • Quantity Limit: limit maximum 30 EA PER 30 day(s)
  • Prior Authorization: Respiratory Syncytial Virus (RSV):
    Documented Diagnosis: Yes
    Duration: 5 Month(s)