| Anthem Blue Cross (HMO, PPO, EPO) |
| Portrazza (necitumumab) |
| Drugs for Cancer : Drugs for Cancer |
- Prior Authorization: NSCLC EGFR Mutated:
Duration: 1 year(s)
- NSCLC EGFR Mutated:
Duration: 1 year(s)
Documented Diagnosis: No
Medical Test Required: No
Reauthorization Required: No
Duration of Reauthorization: N/A
- Step Therapy: NSCLC EGFR Mutated:
ST Multiple Generics
- Available only through Specialty Pharmacy;
|