| Anthem Blue Cross (HMO, PPO, EPO) |
| lapatinib (lapatinib) |
| Drugs for Cancer : Drugs for Cancer |
- May be covered under Medical Benefit.
- Quantity Limit: limit maximum 60 EA PER 30 day(s)
- Prior Authorization: EDS due to OSA, Idiopathic Hypersomnia:
Documented Diagnosis: Yes
Duration: 12 Month(s)
Reauthorization Required: Yes
Neurology: Narcolepsy:
PA Applies
- May be covered under Medical Benefit.
|