| Anthem Blue Cross (HMO, PPO, EPO) |
| Cabometyx (cabozantinib) |
| Drugs for Cancer : Drugs for Cancer |
- Quantity Limit: limit maximum 1 EA PER 1 day(s)
- Quantity Limit: 50 grams per 30 day(s).
- Prior Authorization: Myelofibrosis:
Documented Diagnosis: Yes
Medical Test Required: Yes
Duration: 6 Month(s)
Reauthorization Required: Yes
- Quantity Limit: limit maximum 3 EA PER 1 day(s)
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