Xalkori

Covered Uses:	All FDA approved indications not otherwise excluded from Part D.
Exclusion Criteria:
Required Medical Information:	ALK positive measured by either Abbott's Vysis ALK Break Apart FISH probe test or another reliable CLIA approved testing method (for example RT-PCR, FISH, or IHC) locally advanced or metastatic NSCLC
Age Restrictions:
Prescriber Restrictions:
Coverage Duration:	12months
Other Criteria:

Last Modified on 12/20/2012