505 | 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 |
506 | For patients with chronic Hepatitis B infection who have a contraindication, intolerance or inadequate response to one or more of the following: lamivudine, tenofovir, adefovir or telbivudine. |
| LU Authorization Period: 1 year |
507 | Patients with chronic Hepatitis B infection currently receiving treatment with entecavir and requires treatment continuation. |
| LU Authorization Period: 1 year |
508 | Patients with chronic Hepatitis B infection who are scheduled to undergo chemotherapy or significant immunosuppressive treatment. |
| LU Authorization Period: 1 year |