- Prior Authorization: Chorea in Huntington's Disease:
Documented Diagnosis: Yes
Duration: 3 Month(s)
Reauthorization Required: Yes
- Diabetic Medical Supplies:
Duration: 1 year(s)
Documented Diagnosis: No
Medical Test Required: No
Reauthorization Required: No
Duration of Reauthorization: N/A
- Prior Authorization: Cervical Cancer, Colorectal Cancer, Diabetic Retinopathy, Macular Edema, Macular Edema Following Retinal Vein Occlusion (RVO), Neovascular (Wet) Age-Related Macular Degeneration (AMD), NSCLC Systemic Therapy, Ovarian Cancer, Recurrent Glioblastoma:
Documented Diagnosis: Yes
Duration: 1 year(s)
Kidney Cancer:
Documented Diagnosis: Yes
Medical Test Required: Yes
Duration: 1 year(s)
- Peanut Allergy:
Age Requirement: >= 4
Duration: 12 Month(s)
Specialist Required: Yes
Documented Diagnosis: Yes
Medical Test Required: Yes
Reauthorization Required: Yes
Duration of Reauthorization: = 12 month(s)
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