| UnitedHealthcare |
| FortisCare G1 Test Strip (blood sugar diagnostic) |
| Medical Supplies and Durable Medical Equipment : Medical Supplies and Durable Medical Equipment |
- Diabetic Medical Supplies:
Duration: 12 Month(s)
Documented Diagnosis: Yes
Medical Test Required: No
Reauthorization Required: No
Duration of Reauthorization: N/A
- Quantity Limit: QL= 300 test strips per month at retail. x3 at mail.
- Prior Authorization: Diabetic Medical Supplies:
Documented Diagnosis: Yes
Duration: 12 Month(s)
|