Anthem Blue Cross (HMO, PPO, EPO)
NovoLIN N (insulin NPH isoph U-100 human)
Hormones : Drugs for Diabetes
  • Quantity Limit: limit maximum 3 EA PER fill retail
  • Chemo-induced Nausea and Vomiting (CINV):
    Duration: 6 Month(s)
    Documented Diagnosis: Yes
    Medical Test Required: No
    Reauthorization Required: No
    Duration of Reauthorization: N/A
    NV associated with highly emetogenic cancer chemotherapy (HEC): Yes
    NV associated with moderately emetogenic cancer chemotherapy (MEC): Yes
    Concomitant therapy with Corticosteroid: No
    Concomitant therapy with 5-HT3 Antagonist: No

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