| Anthem Blue Cross (HMO, PPO, EPO) |
| Faslodex 125 Mg/2.5 Syrg (fulvestrant) |
| Drugs for Cancer : Drugs for Cancer |
- Prior Authorization: Breast Cancer: HR+ (HER2+):
Documented Diagnosis: Yes
Duration: 1 year(s)
- Breast Cancer: HR+ (HER2+):
Duration: 1 year(s)
Documented Diagnosis: Yes
Medical Test Required: No
Reauthorization Required: No
Duration of Reauthorization: N/A
|