Anthem Blue Cross - 2014 to Present (HMO, PPO, EPO)
Keppra XR (levetiracetam)
Drugs for the Nervous System : Drugs for Seizures /Personality Disorder/Nerve Pain
  • PA_APPLIES
  • Osteoarthritis: OA of the Knee:
    Duration: 6 Month(s)
    Specialist Required: Yes
    Documented Diagnosis: Yes
    Medical Test Required: No
    Specialist Type(s): 1 of Orthopedic Specialist;Rheumatologist;Sports Medicine Specialist
    Reauthorization Required: Yes
    Duration of Reauthorization: = 6 month(s)
    Elapsed Duration Since Previous Course of Therapy: 6 month(s)

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