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Xarelto (rivaroxaban tablets [generic for 2.5 mg tablet strength only] and oral suspension [generic])Cigna

Venous Thromboembolism in an Acutely Ill Medical Patient, 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