| Anthem Blue Cross (HMO, PPO, EPO) |
| Infugem (gemcitabine in 0.9 % NaCl) |
| Drugs for Cancer : Drugs for Cancer |
- Quantity Limit: limit maximum 3 EA PER fill retail
- Prior Authorization: ADHD:
Documented Diagnosis: Yes
Age Requirement: >= 4
Duration: 1 year(s)
|