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Lorbrena - Lorlatinib tablet, Film Coated
Blue Cross and Blue Shield of Oklahoma
Blue Cross and Blue Shield of Oklahoma Coverage for Lorbrena - Lorlatinib tablet, Film Coated
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5
Commercial
3
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2
Commercial
Commercial - Employer
PA Required
No Step Therapy
Quantity Limit
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Commercial - PPO
PA Required
No Step Therapy
Quantity Limit
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Commercial - HMO
PA Required
No Step Therapy
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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Health Exchange - HMO - Health Insurance Exchange
PA Required
No Step Therapy
Quantity Limit
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