| Anthem Blue Cross (HMO, PPO, EPO) |
| Triptodur (triptorelin pamoate(pediatric)) |
| Hormones : Drugs for Women |
- Quantity Limit: limit maximum 42 EA PER 30 day(s)
- 1; User Field 13;
- Quantity Limit: 2 units per 1 day(s).
- Quantity Limit: limit maximum 2 EA PER 21 day(s)
|