| UnitedHealthcare |
| Byetta 5 MCG Pen (exenatide) |
| Hormones : Drugs for Diabetes |
- Prior Authorization: PA_APPLIES
- Quantity Limit: limit maximum 30 EA PER 30 day(s)
- Quantity Limit: 2 tablets per 1 day(s).
- Anti-Cancer:Maximum $200 copayment per State Law. Anti-Cancer: Maximum $200 copayment per State Law.
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