| Cigna + Oscar |
| Lenvima (12 MG Daily Dose) (lenvatinib) |
| Drugs for Cancer : Drugs for Cancer |
- PA_APPLIES
- Derm: Acne Vulgaris:
Conditional PA: Yes
Documented Diagnosis: No
Medical Test Required: No
Reauthorization Required: No
Limited to non-cosmetic use: No
- Quantity Limit: limit maximum 5 mL PER 1 day(s)
|