| 682 | For the treatment of low white blood cell count in patients who meet the following criteria:
- Patients who become pregnant during the transition period of July 31, 2024, to January 31, 2025. |
| | LU Authorization Period: 12 months from date of authorization. |
| 683 | For the treatment of low white blood cell count in patients 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: 12 months from date of authorization. |
