| Anthem Blue Cross (HMO, PPO, EPO) |
| Fiasp FlexTouch (insulin aspart (niacinamide)) |
| Hormones : Drugs for Diabetes |
- ST_APPLIES
- Cholangiocarcinoma:
Duration: 1 year(s)
Documented Diagnosis: Yes
Medical Test Required: Yes
Reauthorization Required: No
Duration of Reauthorization: N/A
- Quantity Limit: limit maximum 1 EA PER 1 day(s)
- Quantity Limit: SL (56 tablets per year)
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