| UnitedHealthcare |
| Pregnyl (chorionic gonadotropin, human) |
| Hormones : Drugs for Women |
- Assisted Reproductive Technology (ART):
Duration: 2 Month(s)
Documented Diagnosis: Yes
Medical Test Required: No
Specialty Pharmacy Provider(s): 1 of Avella Specialty Pharmacy;Freedom Fertility Pharmacy
Reauthorization Required: No
Duration of Reauthorization: N/A
- Prior Authorization: Assisted Reproductive Technology (ART):
Documented Diagnosis: Yes
Duration: 2 Month(s)
|