Limited Use Note(s) |
|
ENOXAPARIN40mg/0.4mL Pref Syr-0.4mL Pk
| Reason For Use Code | Clinical Criteria |
|---|---|
| 678 | For the treatment of pulmonary embolism, deep vein thrombosis who meet the following criteria: - Patients who become pregnant during the transition period of July 31, 2024, to January 31, 2025. |
| LU Authorization Period: Up to 12 months | |
| 679 | For the treatment of pulmonary embolism, deep vein thrombosis who meet the following criteria: - Patients who require palliative care during the transition period of July 31, 2024, to January 31, 2025. |
| LU Authorization Period: Up to 12 months |