Leuprolide Acetate For Depot Suspension
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Aetna Rx - MEDICARE - Lupron Depot (leuprolide acetate …
www.aetna.comLupron Depot ® (leuprolide acetate for depot suspension) Medication Precertification Request. Page 1 of 3 . For Medicare Advantage Part B: Phone: 1-866-503-0857 . FAX: 1-844-268-7263 . For other lines of business: Please use other form . Note: Lupron Depot is non-preferred. The preferred product is Eligard. Firmagon is also a
Prescription Drug Listing - Horizon NJ Health
www.horizonnjhealth.comsuspension, powder, vial* acyclovir ointment @* ADACEL @* ADCIRCA@* ADVIL COLD AND SINUS AGGRENOX* ... calcium acetate CALDEROL CAMPRAL* CANASA capecitabine @* CAPITROL CARBAGLU carbidopa* ... leuprolide@* levetiracetam, ER* levobunolol levocarnitine levocetirizine 5mg* levofloxacin*
Oncology Medication Clinical Coverage
www.uhcprovider.comacetate, leuprolide acetate, leucovorin and levoleucovorin), including therapeutic radiopharmaceuticals, covered under the medical benefit based upon the National Comprehensive Cancer Network (NCCN) Drugs & Biologics Compendium® (NCCN Compendium®). The Compendium lists the appropriate drugs and biologics for specific …