Sharp Health Plan
Lenvima (8 MG Daily Dose) (lenvatinib)
Drugs for Cancer : Drugs for Cancer
  • Quantity Limit: limit maximum 3 EA PER fill retail
  • Prior Authorization: Hidradenitis Suppurativa (HS):
    Documented Diagnosis: Yes
    Medical Test Required: Yes
    Age Requirement: >= 12
    Duration: 1 year(s)
    Reauthorization Required: Yes

    Psoriasis (PsO):
    Documented Diagnosis: Yes
    Medical Test Required: Yes
    Age Requirement: >= 18
    Duration: 1 year(s)
    Reauthorization Required: Yes

    Uveitis:
    Documented Diagnosis: Yes
    Duration: 1 year(s)

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