| Health Net |
| Endometrin (progesterone micronized) |
| Hormones : Drugs for Women |
- Prior Authorization: Cystic Fibrosis (CF):
Documented Diagnosis: Yes
Medical Test Required: Yes
Duration: 12 Month(s)
Reauthorization Required: Yes
- Quantity Limit: 204 lancets per 30 day(s).
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