Anthem Blue Cross (HMO, PPO, EPO)
Mepsevii (vestronidase alfa-vjbk)
Drugs for Metabolic Disease : Drugs for Metabolic Disease
  • Quantity Limit: 2 tablets per 1 day(s).
  • Quantity Limit: 200 syringes per 30 day(s).
  • Chemo-induced Nausea and Vomiting (CINV):
    Documented Diagnosis: Yes
    Medical Test Required: No
    Reauthorization Required: Yes
    Duration of Reauthorization: Unspecified
    NV associated with highly emetogenic cancer chemotherapy (HEC): No
    NV associated with moderately emetogenic cancer chemotherapy (MEC): No
    Concomitant therapy with Corticosteroid: No
    Concomitant therapy with 5-HT3 Antagonist: No

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