| Anthem Blue Cross (HMO, PPO, EPO) |
| Natpara (parathyroid hormone) |
| Hormones : Drugs for Menopause and Bone Loss |
- Quantity Limit: limit maximum 4 EA PER fill retail
- Prior Authorization: Assisted Reproductive Technology (ART):
Documented Diagnosis: Yes
Duration: 2 Month(s)
- HIV Lipodystrophy:
Age Requirement: >= 18
Duration: 6 Month(s)
Documented Diagnosis: Yes
Medical Test Required: No
Reauthorization Required: Yes
Duration of Reauthorization: >= 6 month(s)
- Step Therapy: Anxiety:
ST Multiple Generics
|