- Obesity:
Age Requirement: >= 12
Duration: 12 week(s)
Documented Diagnosis: Yes
Medical Test Required: No
Reauthorization Required: Yes
Duration of Reauthorization: = 12 week(s)
- Prior Authorization: Obesity:
Documented Diagnosis: Yes
Age Requirement: >= 12
Duration: 12 week(s)
Reauthorization Required: Yes
|