642 | Patient established on therapy prior to March 31, 2023 who is or has become pregnant during the biosimilar transition period between March 31, 2023 to December 28, 2023. |
| LU Authorization Period: One period of up to 12 months |
643 | Patient established on therapy prior to March 31, 2023 who is or becomes palliative requiring end-of-life care during the biosimilar transition period between March 31, 2023 to December 28, 2023. |
| LU Authorization Period: One period of up to 12 months |
644 | Patient requires insulin therapy and is unable to use the insulin pen. |
| LU Authorization Period: 1 year |