| Anthem Blue Cross (HMO, PPO, EPO) |
| Alunbrig (brigatinib) |
| Drugs for Cancer : Drugs for Cancer |
- Prior Authorization: Pain Narcotic: Opioid:
Documented Diagnosis: Yes
Duration: 1 Month(s)
- May be covered under Medical Benefit.
- PA_APPLIES
- Prior Authorization: Documented Diagnosis: Yes
Duration: 12 Month(s)
Reauthorization Required: Yes
- Quantity Limit: 1 unit per 12 week(s).
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