| Anthem Blue Cross (HMO, PPO, EPO) |
| Segluromet (ertugliflozin-metformin) |
| Hormones : Drugs for Diabetes |
- Age Limit: This drug may require prior authorization if your age does not fall within manufacturer, FDA, or clinical recommendations.
Up to 6 yrs old
Preventive Drug: $0 copay.
- Quantity Limit: 1 inhaler per 30 day(s).
- May be covered under Medical Benefit.
- Quantity Limit: limit maximum 60 EA PER 30 day(s)
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