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Imatinib Mesylate - Imatinib Mesylate tablet
Blue Cross and Blue Shield of Minnesota
Blue Cross and Blue Shield of Minnesota Coverage for Imatinib Mesylate - Imatinib Mesylate tablet
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5
Commercial
2
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1
Managed Medicaid
1
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1
Commercial
Commercial - PPO
PA Required
No Step Therapy
Quantity Limit
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Commercial - Employer
No PA
No Step Therapy
No Quantity Limit
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Health Exchange
Health Exchange - PPO - Health Insurance Exchange
PA Required
No Step Therapy
Quantity Limit
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Managed Medicaid
Managed Medicaid - HMO - Medicaid
PA Required
No Step Therapy
Quantity Limit
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Medicare
Medicare - Medicare Advantage Part D
PA Required
No Step Therapy
Quantity Limit
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