| Anthem Blue Cross - 2014 to Present (HMO, PPO, EPO) |
| cyclopentolate (cyclopentolate) |
| Drugs for the Eye : Drugs for the Eye |
- ST_APPLIES
- Diabetic Medical Supplies:
Duration: 1 plan year
Documented Diagnosis: Yes
Medical Test Required: No
Reauthorization Required: Yes
Duration of Reauthorization: = 1 plan year
|