Anthem Blue Cross (HMO, PPO, EPO) |
Libtayo (cemiplimab-rwlc) |
Drugs for Cancer : Drugs for Cancer |
- PA Applies
For FAX form click HERE Our electronic prior authorization (ePA) process is the preferred method for submitting pharmacy prior authorization requests. Creating an account is free, easy and helps patients get their medications sooner. You can complete the process through your current electronic health record/electronic medical record (EHR/EMR) system or by using one of these ePA sites: Log in to Surescripts Log in to CoverMyMeds; For details on drug coverage click HERE;
- Prior Authorization: Basal Cell Carcinoma, Cutaneous Squamous Cell Carcinoma (cSCC):
Documented Diagnosis: Yes
Duration: 1 year(s)
NSCLC Systemic Therapy: Documented Diagnosis: Yes
Medical Test Required: Yes
Duration: 1 year(s)
- Basal Cell Carcinoma, Cutaneous Squamous Cell Carcinoma (cSCC):
Duration: 1 year(s)
Documented Diagnosis: Yes
Medical Test Required: No
Reauthorization Required: No
Duration of Reauthorization: N/A
NSCLC Systemic Therapy: Duration: 1 year(s)
Documented Diagnosis: Yes
Medical Test Required: Yes
Reauthorization Required: No
Duration of Reauthorization: N/A
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