Xarelto (rivaroxaban tablets [generic for 2.5 mg tablet strength only] and oral suspension [generic]) — Cigna
Deep Vein Thrombosis in a Patient Undergoing Knee or Hip Replacement Surgery, Prophylaxis
Initial criteria
- Patient age ≥ 18 years
- If rivaroxaban oral suspension (brand or generic product) is being requested, patient is unable to have Xarelto tablets appropriately administered
Approval duration
60 days