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Specialty Pharmacy Clinical Policy Bulletins
Aetna Non-Medicare Prescription Drug Plan
Subject: Specialty Quantity Limit Tymlos 1916-H P2025
Policy: Program DescriptionThe initial limit is designed to allow a quantity sufficient for the most common uses of the medication. The recommended dosing parameters for all FDA approved indications fall within the standard limits. Coverage of an additional quantity may be reviewed on a case-by-case basis upon request. Covered Quantities
FDA-recommended Dosing80 mcg subcutaneously once daily Place of Service: Outpatient The above policy is based on the following references:
April 29, 2026 |
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