| Anthem Blue Cross - 2014 to Present (HMO, PPO, EPO) |
| Visudyne (verteporfin) |
| Drugs for the Eye : Drugs for the Eye |
- ST_APPLIES
- Diabetic Peripheral Neuropathy:
Duration: 6 Month(s)
Documented Diagnosis: Yes
Medical Test Required: No
Reauthorization Required: Yes
Duration of Reauthorization: = 6 month(s)
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