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Vitrakvi - Larotrectinib capsule
Blue Cross and Blue Shield of Kansas (MCO)
Blue Cross and Blue Shield of Kansas (MCO) Coverage for Vitrakvi - Larotrectinib capsule
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6
Commercial
2
Health Exchange
2
Medicare
2
Commercial
Commercial - HMO
PA Required
No Step Therapy
No Quantity Limit
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Commercial - PPO
PA Required
No Step Therapy
No Quantity Limit
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Health Exchange
Health Exchange - HDHP - Health Insurance Exchange
PA Required
No Step Therapy
No Quantity Limit
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Health Exchange - PPO - Health Insurance Exchange
PA Required
No Step Therapy
No Quantity Limit
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Medicare
Medicare - Prescription Drug Plan
PA Required
No Step Therapy
Quantity Limit
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Medicare - Medicare Advantage Part D
PA Required
No Step Therapy
Quantity Limit
See Details
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