Anthem Blue Cross (HMO, PPO, EPO)
Cambia (diclofenac potassium)
Drugs for Pain and Fever : Arthritis and Pain Drugs
  • Prior Authorization: Acute Migraine:
    Documented Diagnosis: Yes
    Duration: 1 year(s)

  • Acute Migraine:
    Duration: 1 year(s)
    Documented Diagnosis: Yes
    Medical Test Required: No
    Reauthorization Required: No
    Duration of Reauthorization: N/A

  • Step Therapy: Acute Migraine:
    ST Multiple Generics

  • Quantity Limit: 9 packets per 30 day(s).
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