Anthem Blue Cross (HMO, PPO, EPO)
Durolane (
hyaluronate sodium, stabilized
)
Drugs for Muscles, Ligaments, Tendons, and Bones : Drugs for Muscles, Ligaments, Tendons, and Bones
PA_APPLIES
Prior Authorization: PA_APPLIES
Quantity Limit: 204 strips per 30 day(s).
May be covered under Medical Benefit.
Quantity Limit: 1 tablet per 1 day(s).
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