Anthem Blue Cross (HMO, PPO, EPO)
Busulfex (busulfan)
Drugs for Cancer : Drugs for Cancer
  • Quantity Limit: limit maximum 3 EA PER fill retail
  • Paroxysmal Nocturnal Hemoglobinuria:
    Duration: 6 Month(s)
    Documented Diagnosis: Yes
    Medical Test Required: No
    Reauthorization Required: Yes
    Duration of Reauthorization: = 12 month(s)