- Chronic Lymphocytic Leukemia:
Duration: 12 Month(s)
Specialist Required: Yes
Documented Diagnosis: Yes
Medical Test Required: No
Specialist Type(s): 1 of Hematologist;Oncologist
Reauthorization Required: Yes
Duration of Reauthorization: = 12 month(s)
Drug Policy Based On: Payer Specific
Concomitant Therapy Requirement: chlorambucil
Diagnosis Types: Previously untreated CLL
- Prior Authorization: Chronic Lymphocytic Leukemia:
Documented Diagnosis: Yes
Duration: 12 Month(s)
Reauthorization Required: Yes
|