Anthem Blue Cross (HMO, PPO, EPO) |
NovoLOG FlexPen ReliOn (insulin aspart U-100) |
Hormones : Drugs for Diabetes |
- Quantity Limit: limit maximum 3 EA PER fill retail
- Prior Authorization: ADHD:
Documented Diagnosis: Yes
Age Requirement: >= 4
Duration: 1 year(s)
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