| Anthem Blue Cross (HMO, PPO, EPO) |
| Precision Q-I-D Test (Misc) (blood-glucose meter) |
| Medical Supplies and Durable Medical Equipment : Medical Supplies and Durable Medical Equipment |
- Prior Authorization: Diabetic Medical Supplies:
Duration: 1 year(s)
- Step Therapy: Diabetic Medical Supplies:
ST Multiple Brands
- Diabetic Medical Supplies:
Duration: 1 year(s)
Documented Diagnosis: No
Medical Test Required: No
Reauthorization Required: No
Duration of Reauthorization: N/A
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