| Anthem Blue Cross (HMO, PPO, EPO) |
| Pregnyl (chorionic gonadotropin, human) |
| Hormones : Drugs for Women |
- Available through Specialty Pharmacy;
- PA_APPLIES
- Quantity Limit: limit maximum 30 day(s) supply
- Prior Authorization: Pain Narcotic: Opioid:
Duration: 1 year(s)
|