Health Net
Visco-3 (sodium hyaluronate (viscosup))
Drugs for Muscles, Ligaments, Tendons, and Bones : Drugs for Muscles, Ligaments, Tendons, and Bones
  • Step Therapy 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)

  • Prior Authorization: Osteoarthritis: OA of the Knee:
    Documented Diagnosis: Yes
    Duration: 6 Month(s)
    Reauthorization Required: Yes

<< Return | Back to top