Crinone
| Covered Uses: | All FDA approved indications not otherwise excluded from Part D. Additional coverage for off-label use is provided to support established pregnancy |
| Exclusion Criteria: | Coverage is not provided for infertility |
| Required Medical Information: | |
| Age Restrictions: | |
| Prescriber Restrictions: | |
| Coverage Duration: | 9 months for support of established pregnancy, 12 months for secondary amenorrhea |
| Other Criteria: |
Last Modified on 12/19/2012