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PHARMACY COVERAGE GUIDELINES SECTION: DRUGSORIGINAL EFFECTIVE DATE: LAST REVIEW DATE: LAST CRITERIA REVISION DATE: ARCHIVE DATE:7/21/16 9/20/18 9/20/18NITYR (nitisinone) oral tablet (nitisinone) oral
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Nityr - Blue Cross is a form used to report information on health insurance coverage.
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Individuals who have health insurance coverage through Blue Cross are required to file Nityr - Blue Cross.
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Information such as the policy holder's name, policy number, and coverage dates must be reported on Nityr - Blue Cross.
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