services requiring prior authorization - Oxford Health Plans
services requiring prior authorization - Oxford Health Plans
services requiring prior authorization - Oxford Health Plans
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Clinical Electrical Stimulation for the Treatment of Pain and Muscle Rehabilitation 05/01/2013<br />
Clinical Elidel ® (pimecrolimus) and Protopic ® (tacrolimus) 02/15/2013<br />
Clinical Endoscopic Therapies for Gastroesophageal Reflux Disease (GERD) 01/01/2014<br />
Clinical Epidural Steroid and Facet Joint Injections for Spinal Pain 08/01/2013<br />
Clinical<br />
Epiduroscopy, Epidural Lysis of Adhesions and Functional Anesthetic<br />
Discography<br />
03/01/2013<br />
Clinical<br />
Erectile Dysfunction Agents (Viagra, Levitra, Cialis, Staxyn, Muse,<br />
Caverject, and Edex)<br />
01/01/2013<br />
Clinical Erivedge (Vismodegib) 01/01/2014<br />
Clinical Exjade (Deferasirox) and Ferriprox (Deferiprone) 10/01/2013<br />
Clinical Experimental/Investigational Treatment 01/01/2013<br />
Clinical Experimental/Investigational Treatment for NJ <strong>Plans</strong> 01/01/2013<br />
Clinical Extracorporeal Shock Wave Therapy (ESWT) 07/01/2013<br />
F<br />
Clinical Fecal Calprotectin Testing 04/01/2013<br />
Clinical Fecal DNA Testing 05/01/2013<br />
Clinical Femoroacetabular Impingement Syndrome Treatment 02/01/2013<br />
Clinical Follicle Stimulating Hormones (FSH) Used in the Treatment of Infertility 11/01/2012<br />
Clinical Fulyzaq (Crofelemer) 05/15/2013<br />
G<br />
Clinical Gait Analysis 06/01/2013<br />
Clinical Gastrointestinal Motility Disorders, Diagnosis and Treatment 09/01/2013<br />
Clinical Gattex (Teduglutide [Rdna Origin]), for Injection, for Subcutaneous Use 05/15/2013<br />
Clinical Gene Expression Tests 01/01/2014<br />
Clinical<br />
Genetic Testing for Hereditary Breast and/or Ovarian Cancer Syndrome<br />
(HBOC)<br />
05/01/2013<br />
Clinical Gilotrif (Afatinib) 01/01/2014<br />
Clinical Glaucoma Surgical Treatments 01/01/2014<br />
Clinical Gleevec ® (Imatinib Mesylate) 10/01/2013<br />
Clinical Growth Hormone and Growth Stimulating Products 12/01/2012<br />
Clinical Gynecomastia 07/01/2013<br />
H<br />
Clinical High Frequency Chest Wall Compression Devices 01/01/2014<br />
Clinical Hip Replacement Surgery (Arthoplasty) 01/01/2014<br />
Clinical Hip Resurfacing Arthroplasty 04/01/2013<br />
Clinical Home <strong>Health</strong> Care 01/01/2014<br />
Clinical Home Hemodialysis 05/01/2013<br />
Clinical Home Traction Therapy 08/01/2013<br />
Clinical Hospice Care 08/01/2013<br />
Services Requiring Prior Authorization 4<br />
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