| Western Health Advantage |
| Lyumjev KwikPen (insulin lispro-aabc) |
| Hormones : Drugs for Diabetes |
- Prior Authorization: Documented Diagnosis: Yes
Duration: 1 year(s)
- Prior Authorization: Osteoporosis: Post Menopausal Women:
Documented Diagnosis: Yes
Age Requirement: >= 18
Duration: 6 Month(s)
Reauthorization Required: Yes
|