- NSCLC ALK+ OR ROS1+ Disease:
Age Requirement: < 19
Duration: 12 Month(s)
Documented Diagnosis: Yes
Medical Test Required: Yes
Reauthorization Required: Yes
Duration of Reauthorization: = 12 month(s)
- Quantity Limit: 4 tablets per day
- Prior Authorization: NSCLC ALK+ OR ROS1+ Disease:
Documented Diagnosis: Yes
Medical Test Required: Yes
Age Requirement: < 19
Duration: 12 Month(s)
Reauthorization Required: Yes
- Orally administered anticancer medication.
|