| 517 | Confirmed chronic Hepatitis B infection in persons with
- HBV DNA greater than or equal to 1000 IU/mL
AND
- ALT levels greater than ULN
OR
- Evidence of fibrosis
OR
- Documented evidence of cirrhosis |
| | LU Authorization Period: 1 year |
| 518 | For patients with chronic Hepatitis B infection who have a contraindication, intolerance or inadequate response to one or more of the following: lamivudine, entecavir, adefovir or telbivudine. |
| | LU Authorization Period: 1 year |
| 519 | Patient is pregnant (2nd trimester or later) with HBV DNA greater than 1,000,000 IU/mL. |
| | LU Authorization Period: 1 year |
| 520 | Patients with chronic Hepatitis B infection currently receiving treatment with tenofovir and requires treatment continuation. |
| | LU Authorization Period: 1 year |
| 521 | Patients with chronic Hepatitis B infection who are scheduled to undergo chemotherapy or significant immunosuppressive treatment. |
| | LU Authorization Period: 1 year |
| 522 | For HIV/AIDS. |
| | LU Authorization Period: 1 year |
