| Covered Uses: | All FDA approved indications not otherwise excluded from Part D. |
| Exclusion Criteria: | Coverage is not provided when used in combination with interferon alfa or kinase inhibitors (for example, sorafenib, sunitinib, etc). |
| Required Medical Information: | |
| Age Restrictions: | |
| Prescriber Restrictions: | |
| Coverage Duration: | 12 months |
| Other Criteria: |