Orca1

Data catalog

Insurer medical policies

About 5,811 records

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Continuing the Insurer medical policies list, 1000 records per page, after anthem-cg-lab-27.

  1. anthem-cg-lab-28Prostate Specific Antigen Testing
  2. anthem-cg-lab-29Gamma Glutamyl Transferase Testing
  3. anthem-cg-lab-30Outpatient Laboratory-based Blood Glucose Testing
  4. anthem-cg-lab-32Cancer Antigen 125 Testing
  5. anthem-cg-lab-33Carcinoembryonic Antigen Testing
  6. anthem-cg-lab-35Cancer Antigen 19-9 Testing
  7. anthem-cg-med-02Esophageal pH Monitoring
  8. anthem-cg-med-05Ketogenic Diet for Treatment of Intractable Seizures
  9. anthem-cg-med-08Home Enteral Nutrition
  10. anthem-cg-med-100Surface Electrical Stimulation Devices for Headache and Migraine
  11. anthem-cg-med-19Custodial Care
  12. anthem-cg-med-21Anesthesia Services and Moderate (“Conscious”) Sedation
  13. anthem-cg-med-23Home Health
  14. anthem-cg-med-24Electromyography and Nerve Conduction Studies
  15. anthem-cg-med-26Neonatal Levels of Care
  16. anthem-cg-med-28Iontophoresis
  17. anthem-cg-med-34Monitored Anesthesia Care for Gastrointestinal Endoscopic Procedures
  18. anthem-cg-med-35Retinal Telescreening Systems
  19. anthem-cg-med-37Intensive Programs for Pediatric Feeding Disorders
  20. anthem-cg-med-38Inpatient Admission for Radiation Therapy for Cervical or Thyroid Cancer
  21. anthem-cg-med-39Bone Mineral Density Testing Measurement
  22. anthem-cg-med-40External Ambulatory Cardiac Monitors
  23. anthem-cg-med-41Moderate to Deep Anesthesia Services for Dental Surgery in the Facility Setting
  24. anthem-cg-med-42Maternity Ultrasound in the Outpatient Setting
  25. anthem-cg-med-45Transrectal Ultrasonography
  26. anthem-cg-med-46Ambulatory Electroencephalography
  27. anthem-cg-med-47Fundus Photography
  28. anthem-cg-med-48Scrotal Ultrasound
  29. anthem-cg-med-49Auditory Brainstem Responses (ABRs) and Evoked Otoacoustic Emissions (OAEs) for Hearing…
  30. anthem-cg-med-50Visual, Somatosensory and Motor Evoked Potentials
  31. anthem-cg-med-51Three-Dimensional (3-D) Rendering of Imaging Studies
  32. anthem-cg-med-52Allergy Immunotherapy (Subcutaneous)
  33. anthem-cg-med-53Cervical Cancer Screening Using Cytology and Human Papillomavirus Testing
  34. anthem-cg-med-54Strapping
  35. anthem-cg-med-55Site of Care: Advanced Radiologic Imaging
  36. anthem-cg-med-56Non-Obstetrical Transvaginal Ultrasonography
  37. anthem-cg-med-57Cardiac Stress Testing with Electrocardiogram
  38. anthem-cg-med-59Upper Gastrointestinal Endoscopy in Adults
  39. anthem-cg-med-61Preoperative Testing for Low Risk Invasive Procedures and Surgeries
  40. anthem-cg-med-62Resting Electrocardiogram Screening in Adults
  41. anthem-cg-med-64Transcatheter Ablation of Arrhythmogenic Foci in the Pulmonary Veins
  42. anthem-cg-med-65Manipulation Under Anesthesia
  43. anthem-cg-med-66Cryopreservation of Oocytes or Ovarian Tissue
  44. anthem-cg-med-68Therapeutic Apheresis
  45. anthem-cg-med-69Inhaled Nitric Oxide
  46. anthem-cg-med-70Wireless Capsule Endoscopy for Gastrointestinal Imaging and the Patency Capsule
  47. anthem-cg-med-71Chronic Wound Care in the Home or Outpatient Setting
  48. anthem-cg-med-73Hyperbaric Oxygen Therapy (Systemic/Topical)
  49. anthem-cg-med-74Implantable Ambulatory Event Monitors and Mobile Cardiac Telemetry
  50. anthem-cg-med-76Magnetic Source Imaging and Magnetoencephalography
  51. anthem-cg-med-78Anesthesia Services for Interventional Pain Management Procedures
  52. anthem-cg-med-79Diaphragmatic/Phrenic Nerve Stimulation and Diaphragm Pacing Systems
  53. anthem-cg-med-81Ultrasound Ablation for Oncologic Indications
  54. anthem-cg-med-83Site of Care: Specialty Pharmaceuticals
  55. anthem-cg-med-84Non-Obstetric Gynecologic Duplex Ultrasonography of the Abdomen and Pelvis in the…
  56. anthem-cg-med-85Posterior Segment Optical Coherence Tomography
  57. anthem-cg-med-86Enhanced External Counterpulsation in the Outpatient Setting
  58. anthem-cg-med-88Preimplantation Embryo Biopsy
  59. anthem-cg-med-89Home Parenteral Nutrition
  60. anthem-cg-med-90Chelation Therapy
  61. anthem-cg-med-91Remote Therapeutic and Physiologic Monitoring Services
  62. anthem-cg-med-92Foot Care Services
  63. anthem-cg-med-93Navigational Bronchoscopy
  64. anthem-cg-med-94Vestibular Function Testing
  65. anthem-cg-med-95Transanal Irrigation
  66. anthem-cg-med-96Prefabricated External Infant Ear Molding Systems
  67. anthem-cg-med-97Biofeedback and Neurofeedback
  68. anthem-cg-med-98Parenteral Antibiotics for the Treatment of Lyme Disease
  69. anthem-cg-or-pr-02Prefabricated and Prophylactic Knee Braces
  70. anthem-cg-or-pr-03Custom-made Knee Braces
  71. anthem-cg-or-pr-04Cranial Remodeling Bands and Helmets (Cranial Orthoses)
  72. anthem-cg-or-pr-05Myoelectric Upper Extremity Prosthetic Devices
  73. anthem-cg-or-pr-06Spinal Orthoses: Thoracic-Lumbar-Sacral (TLSO), Lumbar-Sacral (LSO), and Lumbar
  74. anthem-cg-or-pr-08Microprocessor Controlled Lower Limb Prosthesis
  75. anthem-cg-or-pr-09Microprocessor Controlled Knee-Ankle-Foot Orthosis
  76. anthem-cg-rad-26Maternity Ultrasound in the Outpatient Setting
  77. anthem-cg-rehab-02Outpatient Cardiac Rehabilitation
  78. anthem-cg-rehab-03Pulmonary Rehabilitation
  79. anthem-cg-rehab-07Skilled Nursing and Skilled Rehabilitation Services (Outpatient)
  80. anthem-cg-rehab-08Private Duty Nursing in the Home Setting
  81. anthem-cg-rehab-10Site of Care: Outpatient Physical Therapy, Occupational Therapy, and Speech-Language…
  82. anthem-cg-rehab-12Rehabilitative and Habilitative Services in the Home Setting: Physical Medicine/Physical…
  83. anthem-cg-surg-01Colonoscopy
  84. anthem-cg-surg-03Blepharoplasty, Blepharoptosis Repair, and Brow Lift
  85. anthem-cg-surg-05Maze Procedure
  86. anthem-cg-surg-07Vertical Expandable Prosthetic Titanium Rib
  87. anthem-cg-surg-08Sacral Nerve Stimulation as a Treatment of Neurogenic Bladder Secondary to Spinal Cord…
  88. anthem-cg-surg-09Temporomandibular Disorders
  89. anthem-cg-surg-10Ambulatory or Outpatient Surgery Center Procedures
  90. anthem-cg-surg-100Laser Trabeculoplasty and Laser Peripheral Iridotomy
  91. anthem-cg-surg-101Ablative Techniques as a Treatment for Barrett’s Esophagus
  92. anthem-cg-surg-102Alcohol Septal Ablation for Treatment of Hypertrophic Cardiomyopathy
  93. anthem-cg-surg-103Penile Circumcision
  94. anthem-cg-surg-104Intraoperative Neurophysiological Monitoring
  95. anthem-cg-surg-105Corneal Collagen Cross-Linking
  96. anthem-cg-surg-106Venous Angioplasty with or without Stent Placement or Venous Stenting Alone
  97. anthem-cg-surg-108Stereotactic Radiofrequency Pallidotomy
  98. anthem-cg-surg-11Surgical Treatment for Dupuytren's Contracture
  99. anthem-cg-surg-111Open Sacroiliac Joint Fusion
  100. anthem-cg-surg-112Carpal Tunnel Decompression Surgery
  101. anthem-cg-surg-113Tonsillectomy with or without Adenoidectomy for Adults
  102. anthem-cg-surg-114Ophthalmic use of Nd:YAG Laser for Posterior Capsulotomy
  103. anthem-cg-surg-115Mechanical Embolectomy for Treatment of Stroke
  104. anthem-cg-surg-116Surgical Treatment of Hyperhidrosis
  105. anthem-cg-surg-117Balloon Dilation of the Eustachian Tubes
  106. anthem-cg-surg-118Intraocular Anterior Segment Aqueous Drainage Devices (without extraocular reservoir)
  107. anthem-cg-surg-119Treatment of Varicose Veins (Lower Extremities)
  108. anthem-cg-surg-12Penile Prosthesis Implantation
  109. anthem-cg-surg-120Vagus Nerve Stimulation
  110. anthem-cg-surg-121Fetal Surgery for Prenatally Diagnosed Malformations
  111. anthem-cg-surg-122Lingual Frenotomy for Ankyloglossia-Related Feeding Difficulties
  112. anthem-cg-surg-123Autologous Fat Grafting and Injectable Soft Tissue Fillers
  113. anthem-cg-surg-124Viscocanalostomy
  114. anthem-cg-surg-125Canaloplasty
  115. anthem-cg-surg-127Products for Wound Healing and Soft Tissue Grafting: Medically Necessary Uses
  116. anthem-cg-surg-15Endometrial Ablation
  117. anthem-cg-surg-17Trigger Point Injections
  118. anthem-cg-surg-18Septoplasty
  119. anthem-cg-surg-24Functional Endoscopic Sinus Surgery (FESS)
  120. anthem-cg-surg-25Injection Treatment for Morton’s Neuroma
  121. anthem-cg-surg-28Transcatheter Uterine Artery Embolization
  122. anthem-cg-surg-29Lumbar Discography
  123. anthem-cg-surg-30Tonsillectomy for Children with or without Adenoidectomy
  124. anthem-cg-surg-31Treatment of Keloids and Scar Revision
  125. anthem-cg-surg-34Diagnostic Hysteroscopy for Infertility
  126. anthem-cg-surg-35Intracytoplasmic Sperm Injection (ICSI)
  127. anthem-cg-surg-36Adenoidectomy
  128. anthem-cg-surg-37Destruction of Pre-Malignant Skin Lesions
  129. anthem-cg-surg-40Cataract Removal Surgery for Adults
  130. anthem-cg-surg-41Surgical Strabismus Correction
  131. anthem-cg-surg-46Myringotomy and Tympanostomy Tube Insertion
  132. anthem-cg-surg-50Assistant Surgeons
  133. anthem-cg-surg-51Outpatient Cystourethroscopy
  134. anthem-cg-surg-52Site of Care: Hospital-Based Ambulatory Surgical Procedures and Endoscopic Services
  135. anthem-cg-surg-55Cardiac Electrophysiological Studies (EPS) and Catheter Ablation
  136. anthem-cg-surg-56Diagnostic Fiberoptic Flexible Laryngoscopy
  137. anthem-cg-surg-57Diagnostic Nasal Endoscopy
  138. anthem-cg-surg-58Radioactive Seed Localization of Nonpalpable Breast Lesions
  139. anthem-cg-surg-59Vena Cava Filters
  140. anthem-cg-surg-61Cryosurgical, Radiofrequency, Microwave or Laser Ablation to Treat Solid Tumors Outside…
  141. anthem-cg-surg-70Gastric Electrical Stimulation
  142. anthem-cg-surg-71Reduction Mammaplasty
  143. anthem-cg-surg-72Endothelial Keratoplasty
  144. anthem-cg-surg-73Balloon Sinus Ostial Dilation
  145. anthem-cg-surg-75Transanal Endoscopic Microsurgical (TEM) Excision of Rectal Lesions
  146. anthem-cg-surg-76Carotid, Vertebral and Intracranial Artery Stent Placement with or without Angioplasty
  147. anthem-cg-surg-77Refractive Surgery
  148. anthem-cg-surg-78Locoregional Techniques for Treating Primary and Metastatic Liver Malignancies
  149. anthem-cg-surg-79Implantable Infusion Pumps
  150. anthem-cg-surg-81Cochlear Implants and Auditory Brainstem Implants
  151. anthem-cg-surg-82Bone-Anchored and Bone Conduction Hearing Aids
  152. anthem-cg-surg-83Bariatric Surgery and Other Treatments for Clinically Severe Obesity
  153. anthem-cg-surg-84Mandibular/Maxillary (Orthognathic) Surgery
  154. anthem-cg-surg-86Endovascular/Endoluminal Repair of Aortic Aneurysms, Aortoiliac Disease, Aortic Dissection…
  155. anthem-cg-surg-87Nasal Surgery for the Treatment of Obstructive Sleep Apnea and Snoring
  156. anthem-cg-surg-88Mastectomy for Gynecomastia
  157. anthem-cg-surg-89Radiofrequency Neurolysis and Pulsed Radiofrequency Therapy for Trigeminal Neuralgia
  158. anthem-cg-surg-90Mohs Micrographic Surgery
  159. anthem-cg-surg-91Minimally Invasive Ablative Procedures for Epilepsy
  160. anthem-cg-surg-92Paraesophageal Hernia Repair
  161. anthem-cg-surg-93Angiographic Evaluation and Endovascular Intervention for Dialysis Access Circuit…
  162. anthem-cg-surg-94Keratoprosthesis
  163. anthem-cg-surg-95Sacral Nerve Stimulation for Urinary Retention, Urinary Incontinence, and Fecal…
  164. anthem-cg-surg-96Intraocular Telescope
  165. anthem-cg-surg-98Prostate Biopsy using MRI Fusion Techniques
  166. anthem-cg-surg-99Panniculectomy and Abdominoplasty
  167. anthem-cg-ther-rad-07Intravascular Coronary and Non-Coronary Brachytherapy
  168. anthem-cg-trans-02Kidney Transplantation
  169. anthem-cg-trans-03Donor Lymphocyte Infusion for Hematologic Malignancies after Allogeneic Hematopoietic…
  170. anthem-dme-00011Electrical Stimulation as a Treatment for Pain and Other Conditions: Surface and…
  171. anthem-dme-00012Intrapulmonary Percussive Ventilation Devices
  172. anthem-dme-00022Functional Electrical Stimulation (FES); Threshold Electrical Stimulation (TES)
  173. anthem-dme-00025Self-Operated Spinal Unloading Devices
  174. anthem-dme-00030Altered Auditory Feedback Devices for Fluency Disorders
  175. anthem-dme-00032Automated External Defibrillators for Home Use
  176. anthem-dme-00037Cooling Devices and Combined Cooling/Heating Devices
  177. anthem-dme-00038Static Progressive Stretch (SPS) and Patient-Actuated Serial Stretch (PASS) Devices
  178. anthem-dme-00041Ultrasonic Diathermy Devices
  179. anthem-dme-00042Electronic Positional Devices for the Treatment of Obstructive Sleep Apnea
  180. anthem-dme-00043Neuromuscular Electrical Training for the Treatment of Obstructive Sleep Apnea or Snoring
  181. anthem-dme-00044Robotic Arm Assistive Devices
  182. anthem-dme-00046Intermittent Abdominal Pressure Ventilation Devices
  183. anthem-dme-00047Rehabilitative Devices with Remote Monitoring
  184. anthem-dme-00048Virtual Reality-Assisted Therapy Systems
  185. anthem-dme-00049External Upper Limb Stimulation for the Treatment of Tremors
  186. anthem-dme-00050Remote Devices for Intermittent Monitoring of Intraocular Pressure
  187. anthem-dme-00052Brain Computer Interface Rehabilitation Devices
  188. anthem-dme-00053Home Video-Assisted Robotic Rehabilitation Systems
  189. anthem-lab-00003In Vitro Chemosensitivity Assays and In Vitro Chemoresistance Assays
  190. anthem-lab-00011Selected Protein Biomarker Algorithmic Assays
  191. anthem-lab-00015Detection of Circulating Tumor Cells
  192. anthem-lab-00016Fecal Analysis Panels in the Diagnosis of Intestinal Disorders
  193. anthem-lab-00019Proprietary Algorithms for Liver Fibrosis
  194. anthem-lab-00024Immune Cell Function Assay
  195. anthem-lab-00025Topographic Genotyping
  196. anthem-lab-00026Systems Pathology and Multimodal Artificial Intelligence Testing for Cancerous and…
  197. anthem-lab-00027Selected Blood, Serum and Cellular Allergy and Toxicity Tests
  198. anthem-lab-00028Blood-based Biomarker Tests for Multiple Sclerosis
  199. anthem-lab-00029Rupture of Membranes Testing in Pregnancy
  200. anthem-lab-00031Advanced Lipoprotein Testing
  201. anthem-lab-00033Protein Biomarkers for the Screening, Detection and Management of Prostate Cancer
  202. anthem-lab-00034Serological Antibody Testing For Helicobacter Pylori
  203. anthem-lab-00035Multi-biomarker Disease Activity Blood Tests for Rheumatoid Arthritis
  204. anthem-lab-00036Multiplex Autoantigen Microarray Testing for Systemic Lupus Erythematosus
  205. anthem-lab-00037Serologic Testing for Biomarkers of Irritable Bowel Syndrome (IBS)
  206. anthem-lab-00039Combined Pathogen Identification and Drug Resistance Testing
  207. anthem-lab-00040Serum Biomarker Tests for Risk of Preeclampsia
  208. anthem-lab-00041Machine Learning Derived Probability Score for Rapid Kidney Function Decline
  209. anthem-lab-00042Molecular Signature Test for Predicting Response to Tumor Necrosis Factor Inhibitor…
  210. anthem-lab-00044Saliva-based Testing to Determine Drug-Metabolizer Status
  211. anthem-lab-00045Selected Tests for the Evaluation and Management of Infertility
  212. anthem-lab-00046Testing for Biochemical Markers for Alzheimer’s Disease
  213. anthem-lab-00048Analysis of Urine Biomarkers for Chronic Pain Management
  214. anthem-lab-00049Artificial Intelligence-Based Software for Prostate Cancer Detection
  215. anthem-lab-00050Metagenomic Sequencing for Infectious Disease in the Outpatient Setting
  216. anthem-lab-00051Per- and Polyfluoroalkyl Substances (PFAS) Testing
  217. anthem-med-00002Selected Sleep Testing Services
  218. anthem-med-00004Noninvasive Imaging Technologies for the Evaluation of Skin Lesions
  219. anthem-med-00011Sensory Stimulation for Brain-Injured Individuals in Coma or Vegetative State
  220. anthem-med-00013Parenteral Antibiotics for the Treatment of Lyme Disease
  221. anthem-med-00053Non-Invasive Measurement of Left Ventricular End Diastolic Pressure in the Outpatient…
  222. anthem-med-00055Wearable Cardioverter Defibrillators
  223. anthem-med-00057MRI Guided High Intensity Focused Ultrasound Ablation for Non-Oncologic Indications
  224. anthem-med-00059Idiopathic Environmental Illness (IEI)
  225. anthem-med-00082Quantitative Sensory Testing
  226. anthem-med-00087Optical Detection for Screening and Identification of Cervical Cancer
  227. anthem-med-00089Quantitative Muscle Testing Devices
  228. anthem-med-00090Wireless Capsule for the Evaluation of Suspected Gastric and Intestinal Motility Disorders
  229. anthem-med-00091Rhinophototherapy
  230. anthem-med-00092Automated Nerve Conduction Testing
  231. anthem-med-00096Low-Frequency Ultrasound Therapy for Wound Management
  232. anthem-med-00097Neural Therapy
  233. anthem-med-00098Hyperoxemic Reperfusion Therapy
  234. anthem-med-00101Physiologic Recording of Tremor using Accelerometer(s) and Gyroscope(s)
  235. anthem-med-00102Ultrafiltration in Decompensated Heart Failure
  236. anthem-med-00103Automated Evacuation of Meibomian Gland
  237. anthem-med-00104Non-invasive Measurement of Advanced Glycation End Products (AGEs) in the Skin
  238. anthem-med-00105Bioimpedance Spectroscopy Devices for the Detection and Management of Lymphedema
  239. anthem-med-00110Silver-based Products for Wound and Soft Tissue Applications
  240. anthem-med-00111Intracardiac Ischemia Monitoring
  241. anthem-med-00112Autonomic Testing
  242. anthem-med-00115Outpatient Cardiac Hemodynamic Monitoring Using a Wireless Sensor for Heart Failure…
  243. anthem-med-00116Near-Infrared Spectroscopy Scanning for Brain Hematoma Screening
  244. anthem-med-00118Continuous Monitoring of Intraocular Pressure
  245. anthem-med-00120Gene Therapy for Ocular Conditions
  246. anthem-med-00125Biofeedback and Neurofeedback
  247. anthem-med-00128Insulin Potentiation Therapy
  248. anthem-med-00129Gene Therapy for Spinal Muscular Atrophy
  249. anthem-med-00130Surface Electromyography and Electrodermal Activity Sensor Devices for Seizure Monitoring
  250. anthem-med-00131Electronic Home Visual Field Monitoring
  251. anthem-med-00132Autologous Adipose-derived Regenerative Cell Therapy
  252. anthem-med-00133Ingestion Event Monitors
  253. anthem-med-00134Non-invasive Heart Failure and Arrhythmia Management and Monitoring Systems
  254. anthem-med-00135Gene Therapy for Hemophilia
  255. anthem-med-00137Eye Movement Analysis Using Non-spatial Calibration for the Diagnosis of Concussion
  256. anthem-med-00138Wearable Devices for Stress Relief and Management
  257. anthem-med-00139Electrical Impedance Scanning for Cancer Detection
  258. anthem-med-00140Gene Therapy for Beta Thalassemia
  259. anthem-med-00141High-volume Colonic Irrigation
  260. anthem-med-00142Gene Therapy for Cerebral Adrenoleukodystrophy
  261. anthem-med-00143Ingestible Devices for the Treatment of Constipation
  262. anthem-med-00144Gene Therapy for Duchenne Muscular Dystrophy
  263. anthem-med-00145Digital Therapy Devices for Treatment of Amblyopia
  264. anthem-med-00146Gene Therapy for Sickle Cell Disease
  265. anthem-med-00147Cellular Therapy Products for Allogeneic Stem Cell Transplantation
  266. anthem-med-00148Gene Therapy for Metachromatic Leukodystrophy
  267. anthem-med-00150Hepzato Kit™ (melphalan hepatic delivery system)
  268. anthem-med-00151Gene Therapy for Aromatic L-Amino Acid Decarboxylase Deficiency
  269. anthem-med-00152Outpatient Intravenous Insulin Therapy
  270. anthem-or-pr-00005Upper Extremity Myoelectric Orthoses
  271. anthem-or-pr-00006Powered Robotic Lower Body Exoskeleton Devices
  272. anthem-or-pr-00008Osseointegrated Limb Prostheses
  273. anthem-rad-00034Dynamic Spinal Visualization (Including Digital Motion X-ray and Cineradiography/…
  274. anthem-rad-00038Use of 3-D, 4-D or 5-D Ultrasound in Maternity Care
  275. anthem-rad-00044Magnetic Resonance Neurography
  276. anthem-rad-00053Cervical and Thoracic Discography
  277. anthem-rad-00057Near-Infrared Coronary Imaging and Near-Infrared Intravascular Ultrasound Coronary Imaging
  278. anthem-rad-00059Catheter-based Embolization Procedures for Malignant Lesions Outside the Liver
  279. anthem-rad-00061PET/MRI
  280. anthem-rad-00063Magnetization-Prepared Rapid Acquisition Gradient Echo Magnetic Resonance Imaging (MPRAGE…
  281. anthem-rad-00064Myocardial Sympathetic Innervation Imaging with or without Single-Photon Emission Computed…
  282. anthem-rad-00065Radiostereometric Analysis (RSA)
  283. anthem-rad-00067Quantitative Ultrasound for Tissue Characterization
  284. anthem-rad-00068Myocardial Strain Imaging
  285. anthem-rad-00069Absolute Quantitation of Myocardial Blood Flow Measurement
  286. anthem-surg-00005Partial Left Ventriculectomy
  287. anthem-surg-00008Mechanized Spinal Distraction Therapy
  288. anthem-surg-00010Treatments for Urinary Incontinence
  289. anthem-surg-00011Products for Wound Healing and Soft Tissue Grafting: Investigational
  290. anthem-surg-00019Transmyocardial Revascularization
  291. anthem-surg-00023Breast Procedures; including Reconstructive Surgery, Implants and Other Breast Procedures
  292. anthem-surg-00026Deep Brain, Cortical, and Cerebellar Stimulation
  293. anthem-surg-00032Patent Foramen Ovale and Left Atrial Appendage Closure Devices
  294. anthem-surg-00043Electrothermal Shrinkage of Joint Capsules, Ligaments, and Tendons
  295. anthem-surg-00044Breast Ductal Examination and Fluid Cytology Analysis
  296. anthem-surg-00045Extracorporeal Shock Wave Therapy
  297. anthem-surg-00047Transendoscopic Therapy for Gastroesophageal Reflux Disease, Dysphagia or Gastroparesis
  298. anthem-surg-00052Percutaneous Vertebral Disc Procedures
  299. anthem-surg-00056Transanal Radiofrequency Treatment of Fecal Incontinence
  300. anthem-surg-00061Presbyopia and Astigmatism-Correcting Intraocular Lenses
  301. anthem-surg-00062Vein Embolization as a Treatment for Pelvic Congestion Syndrome and Varicocele
  302. anthem-surg-00071Percutaneous and Endoscopic Spinal Surgery
  303. anthem-surg-00072Lysis of Epidural Adhesions
  304. anthem-surg-00073Epiduroscopy
  305. anthem-surg-00075Intervertebral Stabilization Devices
  306. anthem-surg-00076Nerve Graft after Prostatectomy
  307. anthem-surg-00077Uterine Fibroid Ablation: Laparoscopic, Percutaneous or Transcervical Image Guided…
  308. anthem-surg-00079Nasal Valve Repair
  309. anthem-surg-00084Implantable Middle Ear Hearing Aids
  310. anthem-surg-00088Coblation® Therapies for Musculoskeletal Conditions
  311. anthem-surg-00089Self-Expanding Absorptive Sinus Ostial Dilation
  312. anthem-surg-00092Implanted Devices for Spinal Stenosis
  313. anthem-surg-00095Viscocanalostomy and Canaloplasty
  314. anthem-surg-00096Surgical and Ablative Treatments for Chronic Headaches
  315. anthem-surg-00097Scoliosis Surgery
  316. anthem-surg-00099Convection-Enhanced Delivery of Therapeutic Agents to the Brain
  317. anthem-surg-00100Cryoablation for Plantar Fasciitis and Plantar Fibroma
  318. anthem-surg-00102Artificial Anal Sphincter for the Treatment of Severe Fecal Incontinence
  319. anthem-surg-00104Extraosseous Subtalar Joint Implantation and Subtalar Arthroereisis
  320. anthem-surg-00105Bicompartmental Knee Arthroplasty
  321. anthem-surg-00107Prostate Saturation Biopsy
  322. anthem-surg-00111Axial Lumbar Interbody Fusion
  323. anthem-surg-00112Implantation of Occipital, Supraorbital or Trigeminal Nerve Stimulation Devices (and…
  324. anthem-surg-00113Artificial Retinal Devices
  325. anthem-surg-00114Facet Joint Allograft Implants for Facet Disease
  326. anthem-surg-00116High Resolution Anoscopy Screening for Anal Intraepithelial Neoplasia (AIN) and Squamous…
  327. anthem-surg-00118Bronchial Thermoplasty
  328. anthem-surg-00120Internal Rib Fixation Systems
  329. anthem-surg-00121Transcatheter Heart Valve Procedures
  330. anthem-surg-00123Transmyocardial/Perventricular Device Closure of Ventricular Septal Defects
  331. anthem-surg-00124Carotid Sinus Baroreceptor Stimulation Devices
  332. anthem-surg-00125Radiofrequency and Pulsed Radiofrequency Treatment of Trigger Point Pain
  333. anthem-surg-00126Irreversible Electroporation
  334. anthem-surg-00128Implantable Left Atrial Hemodynamic Monitor
  335. anthem-surg-00129Oral, Pharyngeal and Maxillofacial Surgical Treatment for Obstructive Sleep Apnea or…
  336. anthem-surg-00130Annulus Closure After Discectomy
  337. anthem-surg-00131Lower Esophageal Sphincter Augmentation Devices
  338. anthem-surg-00132Drug-Eluting Devices for Maintaining Sinus Ostial Patency
  339. anthem-surg-00134Interspinous Process Fixation Devices
  340. anthem-surg-00135Renal Sympathetic Nerve Ablation
  341. anthem-surg-00138Laser Treatment for Onychomycosis
  342. anthem-surg-00139Intraoperative Assessment of Surgical Margins During Breast-Conserving Surgery with…
  343. anthem-surg-00140Peripheral Nerve Blocks for Treatment of Neuropathic Pain
  344. anthem-surg-00141Doppler-Guided Transanal Hemorrhoidal Dearterialization
  345. anthem-surg-00142Genicular Procedures for Treatment of Knee Pain
  346. anthem-surg-00144Occipital and Sphenopalatine Ganglion Nerve Block Therapy for the Treatment of Headache…
  347. anthem-surg-00145Mechanical Circulatory Assist Devices (Ventricular Assist Devices, Percutaneous…
  348. anthem-surg-00146Extracorporeal Carbon Dioxide Removal
  349. anthem-surg-00147Synthetic Cartilage Implant for Metatarsophalangeal Joint Disorders
  350. anthem-surg-00148Spectral Analysis of Prostate Tissue by Fluorescence Spectroscopy
  351. anthem-surg-00149Percutaneous Ultrasonic Ablation of Soft Tissue
  352. anthem-surg-00152Wireless Left Ventricular Pacing for Cardiac Resynchronization Therapy
  353. anthem-surg-00153Cardiac Contractility Modulation Therapy
  354. anthem-surg-00154Microsurgical Procedures for the Prevention or Treatment of Lymphedema
  355. anthem-surg-00155Cryosurgery of Peripheral Nerves
  356. anthem-surg-00156Implanted Artificial Iris Devices
  357. anthem-surg-00157Minimally Invasive Treatment of the Posterior Nasal Nerve to Treat Rhinitis
  358. anthem-surg-00158Implantable Peripheral Nerve Stimulation Devices as a Treatment for Pain
  359. anthem-surg-00159Focal Laser Ablation for the Treatment of Prostate Cancer
  360. anthem-surg-00160Implanted Port Delivery Systems to Treat Ocular Disease
  361. anthem-surg-00161Nanoparticle-Mediated Thermal Ablation
  362. anthem-surg-00162Implantable Shock Absorber for Treatment of Knee Osteoarthritis
  363. anthem-surg-00165Histotripsy
  364. anthem-ther-rad-00008Neutron Beam Radiotherapy
  365. anthem-ther-rad-00012Electrophysiology-Guided Noninvasive Stereotactic Cardiac Radioablation
  366. anthem-trans-00004Cell Transplantation (Mesencephalic, Adrenal-Brain and Fetal Xenograft)
  367. anthem-trans-00008Liver Transplantation
  368. anthem-trans-00009Lung and Lobar Transplantation
  369. anthem-trans-00010Autologous and Allogeneic Pancreatic Islet Cell Transplantation
  370. anthem-trans-00011Pancreas Transplantation and Pancreas Kidney Transplantation
  371. anthem-trans-00013Small Bowel, Small Bowel/Liver and Multivisceral Transplantation
  372. anthem-trans-00016Umbilical Cord Blood Progenitor Cell Collection, Storage and Transplantation
  373. anthem-trans-00023Hematopoietic Stem Cell Transplantation for Multiple Myeloma and Other Plasma Cell…
  374. anthem-trans-00024Hematopoietic Stem Cell Transplantation for Select Leukemias and Myelodysplastic Syndrome
  375. anthem-trans-00026Heart/Lung Transplantation
  376. anthem-trans-00027Hematopoietic Stem Cell Transplantation for Pediatric Solid Tumors
  377. anthem-trans-00028Hematopoietic Stem Cell Transplantation for Hodgkin Disease and non-Hodgkin Lymphoma
  378. anthem-trans-00029Hematopoietic Stem Cell Transplantation for Genetic Diseases and Aplastic Anemias
  379. anthem-trans-00030Hematopoietic Stem Cell Transplantation for Germ Cell Tumors
  380. anthem-trans-00031Hematopoietic Stem Cell Transplantation for Autoimmune Disease and Miscellaneous Solid…
  381. anthem-trans-00033Heart Transplantation
  382. anthem-trans-00034Hematopoietic Stem Cell Transplantation for Diabetes Mellitus
  383. anthem-trans-00035Therapeutic use of Stem Cells, Blood and Bone Marrow Products
  384. anthem-trans-00037Uterine Transplantation
  385. anthem-trans-00038Thymus Tissue Transplantation
  386. anthem-trans-00039Portable Normothermic Organ Perfusion Systems
  387. anthem-trans-00040Hand Transplantation
  388. cigna-0004Extracorporeal Shock Wave Therapy (ESWT) for Musculoskeletal Conditions
  389. cigna-0011Transcatheter Closure of Cardiovascular Defects
  390. cigna-0013Endometrial Ablation
  391. cigna-0019Minimally Invasive Anti-Reflux Procedures and Peroral Endoscopic Myotomy (POEM) Procedures
  392. cigna-0027Panniculectomy and Abdominoplasty
  393. cigna-0028Plasma Brain Natriuretic Peptide in the Outpatient Setting
  394. cigna-0030Wheelchairs/Power Operated Vehicles
  395. cigna-0031Phototherapy, Photochemotherapy, and Excimer Laser Therapy for Dermatologic Conditions
  396. cigna-0035Glaucoma Surgical Procedures
  397. cigna-0037Hyperhidrosis: Surgical Treatments
  398. cigna-0040Percutaneous Vertebroplasty, Kyphoplasty and Sacroplasty
  399. cigna-0042Hospital Beds and Pressure Reducing Support Surfaces
  400. cigna-0045Blepharoplasty, Reconstructive Eyelid Surgery, and Brow Lift
  401. cigna-0048Breast Implant Removal
  402. cigna-0049Speech Generating Devices
  403. cigna-0050Ambulatory Assistance Devices
  404. cigna-0051Bariatric Surgery and Procedures
  405. cigna-0052Genetic Testing for Hereditary and Multifactorial Conditions
  406. cigna-0053Hyperbaric and Topical Oxygen Therapies
  407. cigna-0054Ventricular Assist Devices
  408. cigna-0057Mammary Ductoscopy, Aspiration and Lavage
  409. cigna-0058External Counterpulsation
  410. cigna-0063Headache, Occipital, and/or Trigeminal Neuralgia Treatment
  411. cigna-0064Negative Pressure Wound Therapy/Vacuum Assisted Closure (VAC) for Nonhealing Wounds
  412. cigna-0066Tilt Table Testing
  413. cigna-0068Tissue Engineered Skin Substitutes
  414. cigna-0069Airway Clearance Devices in the Ambulatory Setting
  415. cigna-0070Allergy Testing and Non-Pharmacologic Treatment
  416. cigna-0073Cardiac Rehabilitation (Phase II Outpatient)
  417. cigna-0084Bone Growth Stimulators: Electrical (Invasive), Ultrasound
  418. cigna-0086Complementary and Alternative Medicine
  419. cigna-0089Infertility Services
  420. cigna-0093Hearing Aids
  421. cigna-0097Plantar Fasciitis Treatments
  422. cigna-0099Tests for the Evaluation of Preterm Labor and Premature Rupture of Membranes
  423. cigna-0103Gastric Pacing/Gastric Electrical Stimulation (GES)
  424. cigna-0104Intervertebral Disc (IVD) Prostheses
  425. cigna-0106Diabetes Equipment and Supplies
  426. cigna-0107Pancreatic Islet Cell Transplantation
  427. cigna-0118Bone Graft Substitutes
  428. cigna-0119Partial Rhinectomy, Rhinoplasty, Vestibular Stenosis Repair and Septoplasty
  429. cigna-0121Inflammatory Bowel Disease - Testing for the Diagnosis and Management
  430. cigna-0125Intraocular Lens Implant
  431. cigna-0127Cervical Cancer Screening Visualization Technologies
  432. cigna-0129Heart, Lung, and Heart-Lung Transplantation
  433. cigna-0132Transplantation Donor Charges
  434. cigna-0136Infant Nutritional Formula
  435. cigna-0137Atherosclerotic Cardiovascular Disease Risk Assessment: Emerging Laboratory Evaluations
  436. cigna-0139Ultrasound Guidance for Trigger Point Injections
  437. cigna-0141Corneal Remodeling for Refractive Errors
  438. cigna-0142Ultrasound in Pregnancy (including 3D, 4D and 5D Ultrasound)
  439. cigna-0146Kidney Transplantation, Pancreas-Kidney Transplantation, and Pancreas Transplantation…
  440. cigna-0148Chromoendoscopy
  441. cigna-0152Breast Reduction
  442. cigna-0153Plasmapheresis
  443. cigna-0156Temporomandibular Joint (TMJ) Disorder Surgery
  444. cigna-0158Surgical Treatments for Obstructive Sleep Apnea
  445. cigna-0159Benign Prostatic Hyperplasia (BPH) Surgical Treatments
  446. cigna-0160Electrical Stimulation Therapy and Devices in a Home Setting
  447. cigna-0174Cardiac Resynchronization Therapy
  448. cigna-0175Fetal Surgery
  449. cigna-0176Thermal Shrinkage
  450. cigna-0177Speech Therapy
  451. cigna-0178Breast Reconstruction Following Mastectomy or Lumpectomy
  452. cigna-0181Implantable Cardioverter Defibrillator (ICD)
  453. cigna-0184Deep Brain, Motor Cortex and Responsive Cortical Stimulation
  454. cigna-0190Cochlear and Auditory Brainstem Implants
  455. cigna-0195Gynecomastia Surgery
  456. cigna-0198Continuous Passive Motion (CPM) Devices
  457. cigna-0203Tumor In Vitro Chemosensitivity and Chemoresistance Assays
  458. cigna-0209Orthognathic Surgery
  459. cigna-0215Prostate-Specific Antigen (PSA) Screening for Prostate Cancer
  460. cigna-0225Adoptive Immunotherapy
  461. cigna-0229Staff-Assisted Home Hemodialysis
  462. cigna-0231Attention-Deficit/Hyperactivity Disorder (ADHD): Assessment and Treatment
  463. cigna-0234Varicose Vein Treatments
  464. cigna-0240Reflectance Confocal Microscopy
  465. cigna-0258Neuropsychological Testing
  466. cigna-0261Donor Lymphocyte Infusion and Hematopoietic Progenitor Cell (HPC) Boost
  467. cigna-0266Gender Dysphoria Treatment
  468. cigna-0270Tilt Table Testing
  469. cigna-0273Hospital Beds and Accessories
  470. cigna-0274High Intensity Focused Ultrasound (HIFU)
  471. cigna-0276Manipulation Under Anesthesia
  472. cigna-0277Foot Care Services
  473. cigna-0284Recurrent Pregnancy Loss: Diagnosis and Treatment
  474. cigna-0285Total Ankle Arthroplasty/Replacement
  475. cigna-0287Cell-Based Therapy for Cardiac and Peripheral Arterial Disease
  476. cigna-0288Intestinal and Multivisceral Transplantation
  477. cigna-0300Bone Mineral Density Measurement
  478. cigna-0303Lumbar Fusion for Spinal Instability and Degenerative Disc Conditions, including…
  479. cigna-0308Helicobacter Pylori Serology Testing
  480. cigna-0309Surgical Treatment for Chest Wall Deformities
  481. cigna-0313Treatment of Cutaneous and/or Deep Tissue Hemangioma, Port Wine Stain and Other Vascular…
  482. cigna-0315Gait Analysis
  483. cigna-0320Extracorporeal Photopheresis
  484. cigna-0325Whole Body Dual X-Ray Absorptiometry (DXA)
  485. cigna-0328Scar Revision
  486. cigna-0335Otoplasty and External Ear Reconstruction
  487. cigna-0343Seat Lift Mechanisms, Patient Lifts and Standing Devices
  488. cigna-0350Vagus Nerve Stimulation (VNS)
  489. cigna-0354Compression Devices
  490. cigna-0355Liver and Liver-Kidney Transplantation
  491. cigna-0359Hospitalization for the Initiation of a Ketogenic Diet
  492. cigna-0368Pelvic Denervation Procedures
  493. cigna-0372Oral Cancer Screening Systems
  494. cigna-0383Transcranial Magnetic Stimulation
  495. cigna-0391Diaphragmatic/Phrenic Nerve Stimulation
  496. cigna-0393Discography
  497. cigna-0398Transvaginal Ultrasound, Non-Obstetrical
  498. cigna-0400Lyme Disease Treatment - Antibiotic Treatment
  499. cigna-0403Male Sexual Dysfunction Treatment: Non-pharmacologic
  500. cigna-0404Sacral Nerve Stimulation for Urinary Voiding Dysfunction, Fecal Incontinence and…
  501. cigna-0407Distraction Osteogenesis (DO) for Craniofacial Deformities
  502. cigna-0408Inpatient Admission for Radiation Therapy
  503. cigna-0415Anesthesia and Facility Services for Dental Treatment
  504. cigna-0422Pediatric Intensive Feeding Programs
  505. cigna-0431Cardioverter-Defibrillator Devices
  506. cigna-0439Exhaled Nitric Oxide in the Management of Respiratory Disorders
  507. cigna-0446Metatarsophalangeal Joint Replacement
  508. cigna-0447Autism Spectrum Disorders/Pervasive Developmental Disorders: Assessment and Treatment
  509. cigna-0448Interspinous Process Spacer Devices
  510. cigna-0453Inhaled Nitric Oxide (INO)
  511. cigna-0462Hospice Care
  512. cigna-0465Laboratory Testing for Transplantation Rejection
  513. cigna-0466Umbilical Cord Blood Banking
  514. cigna-0469Atrial Fibrillation: Nonpharmacological Treatments
  515. cigna-0470Redundant Skin Surgery
  516. cigna-0475Carotid Intima-Media Thickness Measurement
  517. cigna-0480Balloon Sinus Ostial Dilation for Chronic Sinusitis and Eustachian Tube Dilation
  518. cigna-0481Drug-Eluting Devices for Use Following Endoscopic Sinus Surgery
  519. cigna-0482Rosacea Procedures
  520. cigna-0486Subtalar Joint Implantation (Subtalar Arthroereisis)
  521. cigna-0493Comparative Genomic Hybridization (CGH)/Chromosomal Microarray Analysis (CMA) for Selected…
  522. cigna-0499Intensive Behavioral Interventions
  523. cigna-0500Pharmacogenetic Testing
  524. cigna-0501Transcatheter Heart Valve Procedures
  525. cigna-0502Bronchial Thermoplasty
  526. cigna-0504Omnibus Codes
  527. cigna-0505Excimer Laser, Dermabrasion and Chemical Peels for Dermatologic Conditions
  528. cigna-0506Autonomic Nerve Function Testing
  529. cigna-0507Autologous Platelet-Derived Growth Factors (Platelet-Rich Plasma [PRP])
  530. cigna-0509Intraoperative Monitoring
  531. cigna-0510Transthoracic Echocardiography in Adults
  532. cigna-0511Injectable Fillers for Head and Neck Conditions
  533. cigna-0513Drug Testing
  534. cigna-0514Genetic Testing for Reproductive Carrier Screening and Prenatal Diagnosis
  535. cigna-0515Miscellaneous Musculoskeletal Procedures
  536. cigna-0516Fecal Bacteriotherapy
  537. cigna-0517Genetic Testing for Hereditary Cardiomyopathies and Arrhythmias
  538. cigna-0518Genetic Testing for Hereditary Cancer Susceptibility Syndromes
  539. cigna-0519Whole Exome and Whole Genome Sequencing for Non-Cancer Indications
  540. cigna-0520Molecular and Proteomic Diagnostic Testing for Hematology and Oncology Indications
  541. cigna-0521Electroencephalography
  542. cigna-0522Athletic Pubalgia Surgery
  543. cigna-0523Transthoracic Echocardiography in Children
  544. cigna-0525Peripheral Nerve Destruction for Pain Conditions
  545. cigna-0526Vitamin D Testing
  546. cigna-0527Cervical Fusion
  547. cigna-0528Laser Interstitial Thermal Therapy
  548. cigna-0529Cardiac Ablation of Abnormal Electrical Rhythms in Adults
  549. cigna-0530Nucleaic Acid Pathogen Testing
  550. cigna-0531Lymphedema and Lipedema Surgical Treatments
  551. cigna-0532Cardiac Electrophysiological (EP) Studies
  552. cigna-0533Stem Cell Transplantation: Blood Cancers
  553. cigna-0534Stem Cell Transplantation: Solid Tumors
  554. cigna-0535Stem Cell Transplantation: Non-cancer Disorders
  555. cigna-0536Prosthetic Devices
  556. cigna-0537Percutaneous Revascularization of the Lower Extermities in Adults
  557. cigna-0538Flow Cytometry
  558. cigna-0539Peripheral Nerve Stimulation and Peripheral Nerve Field Stimulation
  559. cigna-0540Ablative Treatment for Malignant Breast Tumor
  560. cigna-0541Venous Angioplasty and/or Stent Placement in Adults
  561. cigna-0542Duplex Scan of Extracranial Arteries
  562. cigna-0543Orthotic Devices and Shoes
  563. cigna-0545Angioplasty (Extracranial, Intracranial) and Intracranial Aneurysm Repair
  564. cigna-0546Home Ventilators
  565. cigna-0547Ambulatory External and Implantable Electrocardiographic Monitoring
  566. cigna-0548Scrotal Ultrasound
  567. cigna-0549Head and Neck Ultrasound
  568. cigna-0550Site of Care: High-tech Radiology
  569. cigna-0551Anesthesia Services for Interventional Pain Management Procedures in an Adult
  570. cigna-0552Stem Cell Therapy for Orthopaedic Applications
  571. cigna-0553Site of Care: Outpatient Hospital for Select Musculoskeletal Procedures
  572. cigna-0554Diagnostic Nasal/Sinus Endoscopy, Functional Endoscopic Sinus Surgery (FESS) and…
  573. cigna-0555Ambulance Services
  574. cigna-0557COVID-19: In Vitro Diagnostic Testing
  575. cigna-0558Category III Current Procedural Terminology (CPT®) Codes
  576. cigna-0560Vascularized Composite Allograft (VCA) Transplant
  577. cigna-0561Thymus Tissue Transplantation
  578. cigna-0563Remote Physiologic Monitoring (RPM) and Remote Therapeutic Monitoring (RTM)
  579. cigna-0567Serum Folate and Red Blood Cell Folate Testing
  580. cigna-0570Tympanostomy with Iontophoresis Local Anesthesia
  581. cigna-0573Adjustable Continence Therapy
  582. cigna-0574Cardiac Omnibus Codes
  583. cigna-0575Radiofrequency Ablation (RFA) Thyroid Nodules
  584. cigna-0576Radiofrequency Therapy for Fecal Incontinence
  585. cigna-0577Mucosal Integrity Testing
  586. cigna-0578Wide-Area Transepithelial Tissue Sampling with Computer-Assisted 3D Analysis (WATS3D)
  587. cigna-0600Site of Care: Outpatient Hospital Setting for Physical and Occupational Therapy
  588. cigna-0602Ultrasound-guided Radiofrequency Ablation for Uterine Fibroids
  589. cigna-0604Laboratory Testing Services
  590. cigna-1012Fertility Injectables
  591. cigna-1103Complement Inhibitors
  592. cigna-1106Botulinum Therapy
  593. cigna-1201Quantity Limitations
  594. cigna-1206Vascular Endothelial Growth Factor (VEGF) Inhibitors for Ocular Use
  595. cigna-1315Interferon Therapy
  596. cigna-1403Oncology Medications
  597. cigna-1407Pharmacy and Medical Prior Authorization
  598. cigna-1601Standard Prescription Drug List
  599. cigna-1602Drugs Requiring Medical Necessity Review for Employer Plans
  600. cigna-1603Step Therapy Individual and Family Plan
  601. cigna-1605Medication Administration Site of Care
  602. cigna-1701Unassigned Drug Code Outpatient Medical Precertification
  603. cigna-1704Opioid Therapy
  604. cigna-1705Antiemetic Therapy
  605. cigna-1801Step Therapy - Standard/Performance Prescription Drug Lists (Employer Group Plans)
  606. cigna-1802Step Therapy - Value/Advantage Prescription Drug Lists (Employer Group Plans)
  607. cigna-1803Step Therapy - Legacy Prescription Drug Lists (Employer Group Plans)
  608. cigna-1805Immunomodulators – Oral and Subcutaneous (Standard/Performance, Value/Advantage, Legacy…
  609. cigna-1812Etelcalcetide
  610. cigna-1903Immunomodulators – Oral and Subcutaneous (Individual and Family Plans)
  611. cigna-2016COVID-19 Drug and Biologic Therapeutics
  612. cigna-2027Drug and Biologic Medical Necessity (Injectables) - medical benefits
  613. cigna-2028Drug and Biologic Medical Necessity (Non-Injectables) - Medical Benefits
  614. cigna-2029COVID-19 Vaccine
  615. cigna-2102Immunomodulators – Oral and Subcutaneous (Cigna Total Savings Drug List)
  616. cigna-4012Somatropin
  617. cigna-5026Immune Globulin
  618. cigna-6121Pulmonary Hypertension (PH) Therapy
  619. cigna-8007Clotting Factors and Antithrombin
  620. cigna-9001Routine Immunizations
  621. cigna-a001Non-Participating Laboratory Services
  622. cigna-a002Midwife, Home Birth and Non-Clinical Maternal Services
  623. cigna-a003Clinical Trials
  624. cigna-a004Preventive Care Services
  625. cigna-a005Emergency Room Services
  626. cigna-a006Abortion
  627. cigna-a008Authorized Generics
  628. cigna-a011Long Term Care Hospitals (LTCH)
  629. cigna-a012Custodial and Non-Skilled Services
  630. cigna-a015Behavioral Health Coaching and Peer Support Services
  631. cigna-a016Oral Appliances for the Treatment of Obstructive Sleep Apnea
  632. cigna-a018Cigna Healthcare Medicare Advantage Coverage Policy Development and Application
  633. cigna-a022Enteral Formula and Supplies
  634. cigna-cnf001Brand Name Products with Bioequivalent Generics
  635. cigna-cnf002Non-Preferred Drug Coverage Review - (Formulary Exception Criteria)
  636. cigna-cnf0094Estrogen - Transdermal - Step Therapy Policy
  637. cigna-cnf017Opioids Transmucosal - Fentora Formulary Exception Policy
  638. cigna-cnf018Opioids Transmucosal - Lazanda® (fentanyl nasal spray) - Formulary Exception
  639. cigna-cnf019Opioids Transmucosal - Subsys Formulary Exception Policy
  640. cigna-cnf024Attention Deficit Hyperactivity Disorder Non-Stimulant Medications Step Therapy Policy
  641. cigna-cnf025Attention Deficit Hyperactivity Disorder Stimulant Medications Step Therapy Policy
  642. cigna-cnf026Benign Prostatic Hyperplasia - Alpha Blockers - Step Therapy
  643. cigna-cnf027Alzheimer's - Namenda / Namenda XR - Step Therapy
  644. cigna-cnf028Alzheimer's Disease - Step Therapy
  645. cigna-cnf029Angiotensin Receptor Blockers - Step Therapy
  646. cigna-cnf030Antidepressants - Bupropion Long-Acting - Step Therapy
  647. cigna-cnf031Antidepressants - Selective Serotonin Reuptake Inhibitors Step Therapy Policy
  648. cigna-cnf032Antidepressants - Serotonin and Norepinephrine Reuptake Inhibitors Step Therapy Policy
  649. cigna-cnf033Antiseizure Medications - Divalproex Sodium/Valproic Acid Step Therapy Policy
  650. cigna-cnf034Antiepileptics - Lamictal XR - Step Therapy
  651. cigna-cnf035Antiseizure Medications - Levetiracetam, Brivaracetam Step Therapy Policy
  652. cigna-cnf036Antiseizure Medications - Oxcarbazepine Step Therapy Policy
  653. cigna-cnf037Antiepileptics - Topiramate - Step Therapy
  654. cigna-cnf038Topical Antifungals for Onychomycosis - Step Therapy
  655. cigna-cnf039Benign Prostatic Hyperplasia - 5-Alpha-Reductase Inhibitors - Step Therapy
  656. cigna-cnf040Beta Blocker Step Therapy Policy
  657. cigna-cnf041Bile Acid Sequestrants Step Therapy Policy
  658. cigna-cnf043Bisphosphonates (Oral) Enhanced - Step Therapy
  659. cigna-cnf044Calcium Channel Blockers - Dihydropyridine Products Step Therapy Policy
  660. cigna-cnf045Calcium Channel Blockers - Verapamil Products Step Therapy Policy
  661. cigna-cnf046Carbinoxamine Step Therapy Policy
  662. cigna-cnf047Contraceptives - Oral, Patch, and Vaginal Ring Products - Step Therapy
  663. cigna-cnf048Cycloxygenase-2 Inhibitor - Celebrex® (celecoxib capsules - generic) - Step Therapy
  664. cigna-cnf049Diabetes - Dipeptidyl Peptidase-4 Inhibitors Step Therapy Policy
  665. cigna-cnf050Diabetes - Metformin Step Therapy Policy
  666. cigna-cnf051Diabetes - Sodium Glucose Co-Transporter-2 and Dipeptidyl Peptidase-4 Inhibitors Step…
  667. cigna-cnf052Diabetes - Thiazolidinedione Step Therapy Policy
  668. cigna-cnf053Epinephrine Auto-Injectors - Step Therapy
  669. cigna-cnf054Fenofibrate - Step Therapy
  670. cigna-cnf055Gabapentin - Step Therapy
  671. cigna-cnf056Gout Medications - Step Therapy
  672. cigna-cnf057Hydrocortisone Acetate Suppository - Step Therapy
  673. cigna-cnf058Hydroxy-Methylglutaryl-Coenzyme A Reductase Inhibitors Step Therapy Policy
  674. cigna-cnf059Isotretinoin Capsules - Step Therapy
  675. cigna-cnf060Methotrexate Injection - Step Therapy
  676. cigna-cnf061Migraine Medication - Step Therapy
  677. cigna-cnf062Parkinson’s Disease - Monoamine Oxidase Type B Inhibitors - Step Therapy
  678. cigna-cnf063Naloxone Injection - Step Therapy
  679. cigna-cnf064Nasal Steroids Step Therapy Policy
  680. cigna-cnf065Nonsteroidal Anti-Inflammatory Drugs Step Therapy Policy
  681. cigna-cnf066Ophthalmic Anti-Allergics: Mast Cell Stabilizers - Step Therapy
  682. cigna-cnf067Ophthalmic Anti-Allergics - Miscellaneous Step Therapy Policy
  683. cigna-cnf070Proton Pump Inhibitors Step Therapy Policy
  684. cigna-cnf071Sedative Hypnotics - Step Therapy
  685. cigna-cnf072Diabetes - Sodium Glucose Co-Transporter-2 Inhibitors Step Therapy Policy
  686. cigna-cnf073Tetracyclines (Oral) Step Therapy Policy
  687. cigna-cnf074Topical Acne - Cleansers Step Therapy Policy
  688. cigna-cnf075Topical Acne - Kits Step Therapy Policy
  689. cigna-cnf076Topical Acne Products Step Therapy Policy
  690. cigna-cnf077Topical Agents for Atopic Dermatitis Step Therapy Policy
  691. cigna-cnf078Topical Antibacterials - Step Therapy
  692. cigna-cnf079Topical Corticosteroids - Step Therapy
  693. cigna-cnf080Topical Doxepin Step Therapy Policy
  694. cigna-cnf081Topical Medications for Inflammatory Rosacea Step Therapy Policy
  695. cigna-cnf082Vitamin D Analog (Oral) Step Therapy Policy
  696. cigna-cnf083Zetia® (ezetimibe tablets) - Step Therapy
  697. cigna-cnf086Bowel Disease - Opioid-Induced Constipation Preferred Step Therapy Policy
  698. cigna-cnf087Colchicine Products Preferred Step Therapy
  699. cigna-cnf105Ophthalmic Nonsteroidal Anti-Inflammatory Drugs Step Therapy Policy
  700. cigna-cnf108Overactive Bladder Medications Preferred Step Therapy Policy
  701. cigna-cnf110Phosphate Binders Preferred Step Therapy Policy
  702. cigna-cnf116Sickle Cell Disease - Hydroxyurea Products Preferred Step Therapy
  703. cigna-cnf118Antibiotics (Inhaled) - Arikayce Prior Authorization Policy
  704. cigna-cnf119Hepatitis C - Mavyret Prior Authorization for Preferred Specialty Management Policy
  705. cigna-cnf121Bowel Agents - Lubiprostone Drug Quantity Management Policy - Per Rx
  706. cigna-cnf122Calcitonin Gene-Related Peptide Inhibitors - Aimovig Drug Quantity Management Policy - Per…
  707. cigna-cnf124Oncology - Alunbrig Drug Quantity Management Policy - Per Rx
  708. cigna-cnf126Psychiatry - Novel Psychotropics Drug Quantity Management Policy - Per Rx
  709. cigna-cnf128Oncology - Bosulif Drug Quantity Management Policy - Per Rx
  710. cigna-cnf129Oncology - Cabometyx Drug Quantity Management Policy - Per Rx
  711. cigna-cnf130Oncology - Calquence Drug Quantity Management Policy - Per Rx
  712. cigna-cnf131Alpha-Adrenergic Blockers - Doxazosin Drug Quantity Management Policy - Per Rx
  713. cigna-cnf132Hypertension - Clonidine Patches Drug Quantity Management Policy - Per Days
  714. cigna-cnf133Inflammatory Conditions - Cimzia Drug Quantity Management Policy - Per Days
  715. cigna-cnf134Topical Antibiotics for Acne – Clindamycin - Drug Quantity Management
  716. cigna-cnf135Topical Corticosteroids - Clobetasol Drug Quantity Management Policy - Per Days
  717. cigna-cnf139Inflammatory Conditions - Cosentyx Subcutaneous Drug Quantity Management Policy - Per Days
  718. cigna-cnf140Antidepressants - Bupropion Long-Acting Drug Quantity Management Policy - Per Rx
  719. cigna-cnf141Antidepressants - Serotonin and Norepinephrine Reuptake Inhibitors Drug Quantity…
  720. cigna-cnf142Antidepressants - Selective Serotonin Reuptake Inhibitors Drug Quantity Management Policy…
  721. cigna-cnf143Topical Nonsteroidal Anti-Inflammatory Drugs - Diclofenac Drug Quantity Management Policy…
  722. cigna-cnf144Topical Corticosteroids - Diflorasone Drug Quantity Management Policy - Per Days
  723. cigna-cnf145Antifungals - Fluconazole (Oral) Drug Quantity Management Policy - Per Rx
  724. cigna-cnf146Estrogens (Topical) - Estradiol Gel Drug Quantity Management Policy - Per Rx
  725. cigna-cnf147Thrombocytopenia - Doptelet Drug Quantity Management Policy - Per Rx
  726. cigna-cnf148Cabergoline Drug Quantity Management Policy - Per Days
  727. cigna-cnf149Immunologicals - Dupixent Drug Quantity Management Policy - Per Days
  728. cigna-cnf150Calcitonin Gene-Related Peptide Inhibitors - Emgality Drug Quantity Management Policy…
  729. cigna-cnf151Inflammatory Conditions - Etanercept Products Drug Quantity Management Policy - Per Days
  730. cigna-cnf152Hepatitis C - Epclusa Drug Quantity Management Policy - Per Days
  731. cigna-cnf155Erectile Dysfunction Agents Drug Quantity Management Policy - Per Rx
  732. cigna-cnf156Estrogens (Topical) - Patches Drug Quantity Management Policy - Per Days
  733. cigna-cnf157Antivirals - Famciclovir Drug Quantity Management Policy - Per Rx
  734. cigna-cnf158Opioids - Fentanyl Transdermal Products Drug Quantity Management Policy - Per Days
  735. cigna-cnf159Opioids - Fentanyl Transmucosal Products Drug Quantity Management Policy - Per Days
  736. cigna-cnf160Topical Corticosteroids - Fluocinonide Drug Quantity Management Policy - Per Days
  737. cigna-cnf161Topical Corticosteroids - Flurandrenolide Drug Quantity Management Policy - Per Days
  738. cigna-cnf162Oncology - Imatinib Drug Quantity Management Policy - Per Rx
  739. cigna-cnf163Hepatitis C - Harvoni Drug Quantity Management Policy - Per Days
  740. cigna-cnf164Chronic Gonadotropins Quantity Management Policy - Per Rx
  741. cigna-cnf165Hydroxy-Methylglutaryl-Coenzyme A Reductase Inhibitors Drug Quantity Management Policy…
  742. cigna-cnf166Adalimumab injection (Humira®) Duration Limit for 28-Day Period - Drug Quantity…
  743. cigna-cnf167Alpha-Adrenergic Blockers – Terazosin - Drug Quantity Management
  744. cigna-cnf168Inflammatory Conditions - Ilumya Drug Quantity Management Policy - Per Days
  745. cigna-cnf171Oncology - Gefitinib Drug Quantity Management Policy - Per Rx
  746. cigna-cnf172Cushing’s Disease - Isturisa Drug Quantity Management Policy - Per Rx
  747. cigna-cnf173Antifungals - Itraconazole Drug Quantity Management Policy - Per Rx
  748. cigna-cnf174Testosterone Undecanoate (Oral) Drug Quantity Management (DQM) - Per Rx
  749. cigna-cnf175Inflammatory Conditions - Kineret Drug Quantity Management Policy - Per Days
  750. cigna-cnf177Topical Corticosteroids - Hydrocortisone Butyrate Drug Quantity Management Policy - Per…
  751. cigna-cnf178Potassium Binders - Lokelma Drug Quantity Management Policy - Per Rx
  752. cigna-cnf179Hepatitis C - Mavyret Drug Quantity Management Policy - Per Days
  753. cigna-cnf181Diabetes - Metformin Extended-Release Drug Quantity Management Policy - Per Rx
  754. cigna-cnf184Opioids - Morphine Milligram Equivalent (90) Drug Quantity Management Policy
  755. cigna-cnf185Opioid - Morphine Milligram Equivalent (200) - Drug Quantity Management
  756. cigna-cnf186Corticosteroids (Nasal) - Mometasone Drug Quantity Management Policy - Per Rx
  757. cigna-cnf187Antiemetics - Doxylamine and Pyridoxine Combination Products Drug Quantity Management…
  758. cigna-cnf189Antiemetics - Serotonin Receptor Antagonists (Oral and Transdermal) Drug Quantity…
  759. cigna-cnf190Antiemetics - Substance P/Neurokinin-1 Receptor Antagonists (Oral) Drug Quantity…
  760. cigna-cnf192Immunologicals - Nucala Drug Quantity Management Policy - Per Days
  761. cigna-cnf193Opioids - Nucynta Drug Quantity Management Policy - Per Rx
  762. cigna-cnf194Opioids - Short-Acting Products Drug Quantity Management Policy (Adults) - Per Rx
  763. cigna-cnf196Opioids - Short-Acting Products Drug Quantity Management Policy (Pediatrics) - Per Rx
  764. cigna-cnf197Opioids - Long-Acting Products (Oral) Drug Quantity Management Policy - Per Days
  765. cigna-cnf199Gonadotropin-Releasing Hormone Antagonists - Orilissa Drug Quantity Management Policy…
  766. cigna-cnf200Inflammatory Conditions - Otezla Drug Quantity Management Policy - Per Days
  767. cigna-cnf201Sickle Cell Disease - Oxbryta Drug Quantity Management Policy - Per Rx
  768. cigna-cnf202Allergen Immunotherapy - Palforzia Drug Quantity Management Policy - Per Rx
  769. cigna-cnf203Phenylketonuria - Palynziq Drug Quantity Management Policy - Per Rx
  770. cigna-cnf204Infectious Disease - Antiparasitics Drug Quantity Management Policy - Per Rx and Per Days
  771. cigna-cnf205Infectious Disease - Prevymis Drug Quantity Management Policy - Per Days
  772. cigna-cnf206Corticosteroids (Nebulized) - Budesonide - Drug Quantity Management
  773. cigna-cnf207Anti-Influenza - Relenza Drug Quantity Management Policy - Per Rx
  774. cigna-cnf209Pulmonary Arterial Hypertension - Sildenafil Drug Quantity Management Policy - Per Rx
  775. cigna-cnf210Oncology - Rozlytrek Drug Quantity Management Policy - Per Rx
  776. cigna-cnf211Tolvaptan Products Drug Quantity Management Policy - Per Rx
  777. cigna-cnf212Inflammatory Conditions - Siliq Drug Quantity Management Policy - Per Days
  778. cigna-cnf214Inflammatory Conditions - Simponi Subcutaneous Drug Quantity Management Policy - Per Days
  779. cigna-cnf215Inflammatory Conditions - Skyrizi Subcutaneous Drug Quantity Management Policy - Per Days
  780. cigna-cnf218Hepatitis C - Sovaldi Drug Quantity Management Policy - Per Days
  781. cigna-cnf219Spinal Muscle Atrophy - Spinraza Drug Quantity Management Policy - Per Days
  782. cigna-cnf220Oncology - Dasatinib - Drug Quantity Management Policy - Per Rx
  783. cigna-cnf222Inflammatory Conditions - Ustekinumab Subcutaneous Drug Quantity Management Policy - Per…
  784. cigna-cnf224Wakefulness-Promoting Agents - Sunosi Drug Quantity Management Policy - Per Rx
  785. cigna-cnf225Oncology - Sunitinib Drug Quantity Management Policy - Per Rx
  786. cigna-cnf226Inflammatory Conditions - Taltz Drug Quantity Management Policy - Per Days
  787. cigna-cnf227Anti-Influenza - Oseltamivir Drug Quantity Management Policy - Per Rx
  788. cigna-cnf228Oncology - Erlotinib Drug Quantity Management Policy - Per Rx
  789. cigna-cnf230Oncology - Tasigna Drug Quantity Management Policy - Per Rx
  790. cigna-cnf231Bone Modifiers - Teriparatide Drug Quantity Management Policy - Per Days
  791. cigna-cnf232Topical Anesthetics Drug Quantity Management Policy - Per Days
  792. cigna-cnf233Topical Calcipotriene Products Drug Quantity Management Policy - Per Days
  793. cigna-cnf234Topical Collagenase - Santyl Drug Quantity Management Policy - Per Rx
  794. cigna-cnf235Topical Antipruritics - Doxepin Products Drug Quantity Management Policy - Per Days
  795. cigna-cnf236Topical Agents for Atopic Dermatitis Drug Quantity Management Policy - Per Days
  796. cigna-cnf237Testosterone Products (Topical) - Drug Quantity Management
  797. cigna-cnf238Topical Antifungals Drug Quantity Management Policy - Per Days
  798. cigna-cnf239Opioids - Tramadol Extended-Release Products Drug Quantity Management Policy - Per Rx
  799. cigna-cnf240Inflammatory Conditions - Tremfya Drug Quantity Management Policy - Per Days
  800. cigna-cnf241Topical Corticosteroids - Triamcinolone Topical Spray Drug Quantity Management Policy…
  801. cigna-cnf242Oncology - Lapatinib Drug Quantity Management Policy - Per Rx
  802. cigna-cnf243Proton Pump Inhibitors Drug Quantity Management Policy - Per Rx
  803. cigna-cnf245Antivirals - Valacyclovir Drug Quantity Management Policy - Per Rx
  804. cigna-cnf246Infectious Disease - Vancomycin (Oral) Drug Quantity Management Policy - Per Rx
  805. cigna-cnf247Potassium Binders - Veltassa Drug Quantity Management Policy - Per Rx
  806. cigna-cnf248Vesicular Monoamine Transporter Type 2 Inhibitors Drug Quantity Management Policy - Per Rx
  807. cigna-cnf249Hepatitis C - Viekira Pak™ (ombitasvir/paritaprevir/ritonavir tablets; dasabuvir tablets…
  808. cigna-cnf250Wakefulness-Promoting Agents - Wakix Drug Quantity Management Policy - Per Rx
  809. cigna-cnf252Antiseizure Medications - Xcopri Drug Quantity Management Policy - Per Rx
  810. cigna-cnf253Oncology - Xermelo Drug Quantity Management Policy - Per Rx
  811. cigna-cnf255Oncology (Oral - Androgen Biosynthesis Inhibitor) - Abiraterone Acetate Drug Quantity…
  812. cigna-cnf256Hepatitis C - Zepatier Drug Quantity Management Policy - Per Days
  813. cigna-cnf258Antibiotics (Inhaled) - Tobramycin Products Preferred Specialty Management
  814. cigna-cnf259Chorionic Gonadotropins Preferred Specialty Management Policy
  815. cigna-cnf263Gaucher Disease - Substrate Reduction Therapy - Preferred Specialty Management
  816. cigna-cnf264Infertility - Gonadotropin-Releasing Hormone Antagonists - Preferred Specialty Management
  817. cigna-cnf265Growth Hormone - Preferred Specialty Management
  818. cigna-cnf266Colony Stimulating Factors - Pegfilgrastim Products, Rolvedon and Ryzneuta Preferred…
  819. cigna-cnf268Hepatitis C Virus Direct-Acting Antivirals Preferred Specialty Management Policy for…
  820. cigna-cnf270Hereditary Angioedema - Icatibant - Preferred Specialty Management
  821. cigna-cnf276Immunologicals - Asthma Preferred Specialty Management Policy
  822. cigna-cnf277Infertility - Follitropins, Clomiphene Preferred Specialty Management Policy
  823. cigna-cnf278Inflammatory Conditions Preferred Specialty Management Policy for National Preferred, High…
  824. cigna-cnf280Multiple Sclerosis Preferred Specialty Management Policy
  825. cigna-cnf281Multiple Sclerosis - Ampyra® (dalfampridine extended-release tablets, generic) - Preferred…
  826. cigna-cnf282Oncology - Abiraterone Acetate Preferred Specialty Management Policy
  827. cigna-cnf283Oncology - Everolimus Products - Preferred Specialty Management
  828. cigna-cnf284Oncology - Cyclin Dependent Kinases 4, 6 Inhibitors Preferred Specialty Management Policy
  829. cigna-cnf285Oncology - Imbruvica Preferred Specialty Management Policy
  830. cigna-cnf288Pulmonary Arterial Hypertension - Endothelin Receptor Antagonist - Preferred Specialty…
  831. cigna-cnf289Pulmonary Arterial Hypertension - Inhaled Prostacyclin - Preferred Specialty Management
  832. cigna-cnf290Pulmonary Arterial Hypertension - Phosphodiesterase Type 5 Inhibitors - Preferred…
  833. cigna-cnf293Vesicular Monoamine Transporter Type 2 Inhibitors Preferred Specialty Management Policy
  834. cigna-cnf297Allergen Immunotherapy - Grass Pollen Sublingual Products - Prior Authorization
  835. cigna-cnf298Allergen Immunotherapy - Odactra® (house dust mite [Dermatophagoides farina and…
  836. cigna-cnf299Allergen Immunotherapy - Palforzia Prior Authorization Policy
  837. cigna-cnf300Allergen Immunotherapy - Ragwitek® (short ragweed pollen allergen extract sublingual…
  838. cigna-cnf301Amifampridine Products Prior Authorization Policy
  839. cigna-cnf302Amyloidosis - Tafamidis Products - Prior Authorization
  840. cigna-cnf303Amyloidosis - Tegsedi® (inotersen subcutaneous injection) - Prior Authorization
  841. cigna-cnf304Antibiotics - Linezolid (Zyvox), Sivextro - Prior Authorization
  842. cigna-cnf305Antibiotics - Synercid® (quinupristin and dalfopristin powder for injection) - Prior…
  843. cigna-cnf306Antibiotics - Vancomycin Capsules Prior Authorization Policy
  844. cigna-cnf308Antibiotics (Inhaled) - Cayston Prior Authorization Policy
  845. cigna-cnf309Antibiotics (Inhaled) - TOBI Podhaler Prior Authorization Policy
  846. cigna-cnf310Antibiotics (Inhaled) - Tobramycin Inhalation Solution - Prior Authorization
  847. cigna-cnf311Anticoagulants - Eliquis Prior Authorization Policy
  848. cigna-cnf312Anticoagulants - Dabigatran Prior Authorization Policy
  849. cigna-cnf313Anticoagulants - Savaysa® (edoxaban tablet) - Prior Authorization
  850. cigna-cnf314Anticoagulants - Xarelto Prior Authorization with Step Therapy Policy
  851. cigna-cnf315Antiseizure Medications - Fintepla Prior Authorization Policy
  852. cigna-cnf316Antiseizure Medications - Rufinamide Prior Authorization Policy
  853. cigna-cnf317Antiseizure Medications - Clobazam Products Prior Authorization Policy
  854. cigna-cnf318Antiepileptics – Diacomit® (stiripentol capsules and powder for oral suspension)…
  855. cigna-cnf319Antiepileptics –  Epidiolex® (cannabidiol oral solution) - Prior Authorization
  856. cigna-cnf320Antiseizure Medications - Nayzilam Prior Authorization Policy
  857. cigna-cnf321Antiseizure Medications - Vigabatrin Prior Authorization Policy
  858. cigna-cnf323Antifungals - Cresemba (Oral) Prior Authorization Policy
  859. cigna-cnf324Antifungals - Posaconazole (Oral) Prior Authorization Policy
  860. cigna-cnf325Antifungals - Tolsura Prior Authorization with Step Therapy Policy
  861. cigna-cnf326Antifungals - Voriconazole (Oral) - Prior Authorization Policy
  862. cigna-cnf327Infectious Disease - Impavido Prior Authorization Policy
  863. cigna-cnf328Antifungals - Voriconazole (Oral) Prior Authorization Policy
  864. cigna-cnf329Bone Modifiers - Tymlos Prior Authorization Policy
  865. cigna-cnf330Infectious Disease - Sirturo Prior Authorization Policy
  866. cigna-cnf331Migraine - Calcitonin Gene-Related Peptide Inhibitors - Aimovig Prior Authorization Policy
  867. cigna-cnf332Migraine - Calcitonin Gene-Related Peptide Inhibitors - Ajovy Prior Authorization Policy
  868. cigna-cnf333Migraine - Calcitonin Gene-Related Peptide Inhibitors - Emgality Prior Authorization…
  869. cigna-cnf334Contraceptives - Phexxi Prior Authorization Policy
  870. cigna-cnf335Cardiology - Ivabradine Prior Authorization Policy
  871. cigna-cnf336Chelating Agents - Chemet Prior Authorization Policy
  872. cigna-cnf337Gaucher Disease - Substrate Reduction Therapy - Miglustat Prior Authorization Policy
  873. cigna-cnf338Chelating Agents - Penicillamine Products - Prior Authorization
  874. cigna-cnf339Chelating Agents - Syprine® (trientine hydrochloride capsules, generics) - Prior…
  875. cigna-cnf340Chenodiol Products Prior Authorization Policy
  876. cigna-cnf341Cholbam Prior Authorization Policy
  877. cigna-cnf342Cinacalcet tablets (Sensipar®) - Prior Authorization
  878. cigna-cnf346Colony Stimulating Factors - Pegfilgrastim Products - Prior Authorization
  879. cigna-cnf348Pulmonary - Corticosteroid/Long-Acting Beta2-Agonist Combination Inhalers Prior…
  880. cigna-cnf349Cushing’s - Isturisa Prior Authorization Policy
  881. cigna-cnf350Cushing’s - Mifepristone Prior Authorization Policy
  882. cigna-cnf351Cushing’s - Signifor Prior Authorization Policy
  883. cigna-cnf352Cystic Fibrosis Transmembrane Conductance Regulator - Kalydeco Prior Authorization Policy
  884. cigna-cnf353Cystic Fibrosis Transmembrane Conductance Regulator - Orkambi Prior Authorization Policy
  885. cigna-cnf354Cystic Fibrosis - Pulmozyme Prior Authorization Policy
  886. cigna-cnf355Cystic Fibrosis Transmembrane Conductance Regulator - Symdeko Prior Authorization Policy
  887. cigna-cnf356Cystic Fibrosis Transmembrane Conductance Regulator - Trikafta Prior Authorization Policy
  888. cigna-cnf357Pulmonary - Daliresp® (roflumilast tablets) - Prior Authorization
  889. cigna-cnf358Desmopressin Products - Nocdurna® (desmopressin acetate sublingual tablets [27.7 mcg and…
  890. cigna-cnf359Desmopressin Products - Noctiva™ (desmopressin acetate nasal spray [0.83 mcg/0.1 mL and…
  891. cigna-cnf360Diabetes - Glucagon-Like Peptide-1 Agonists Prior Authorization Policy
  892. cigna-cnf361Diabetes - Symlin Prior Authorization Policy
  893. cigna-cnf362Dronabinol - Marinol® (dronabinol capsules), Syndros® (dronabinol oral solution) - Prior…
  894. cigna-cnf363Muscular Dystrophy - Deflazacort Prior Authorization Policy
  895. cigna-cnf364Enzyme Replacement Therapy - Strensiq Prior Authorization Policy
  896. cigna-cnf365Enzyme Replacement Therapy - Sucraid Prior Authorization Policy
  897. cigna-cnf366Erectile Dysfunction - Alprostadil Products Prior Authorization Policy
  898. cigna-cnf367Erectile Dysfunction - Tadalafil Prior Authorization Policy
  899. cigna-cnf368Erectile Dysfunction - Vardenafil Prior Authorization Policy
  900. cigna-cnf369Erectile Dysfunction - Avanafil Prior Authorization Policy
  901. cigna-cnf370Erectile Dysfunction - Sildenafil Prior Authorization Policy
  902. cigna-cnf374Fabry Disease - Galafold Prior Authorization Policy
  903. cigna-cnf375Gastroenterology - Gattex Prior Authorization Policy
  904. cigna-cnf376Gaucher Disease - Substrate Reduction Therapy - Cerdelga Prior Authorization Policy
  905. cigna-cnf377Gaucher Disease - Substrate Reduction Therapy - Miglustat Prior Authorization Policy
  906. cigna-cnf381Gonadotropin-Releasing Hormone Antagonists - Orilissa Prior Authorization Policy
  907. cigna-cnf382Gonadotropin-Releasing Hormone Antagonists - Oriahnn Prior Authorization Policy
  908. cigna-cnf383Growth Disorders - Increlex® (mecasermin [rDNA origin] for subcutaneous injection) - Prior…
  909. cigna-cnf384Growth Disorders - Growth Hormone Prior Authorization Policy
  910. cigna-cnf386Spinal Muscular Atrophy - Evrysdi Prior Authorization Policy
  911. cigna-cnf387Ophthalmology - Upneeq Prior Authorization Policy
  912. cigna-cnf388Enspryng Prior Authorization Policy
  913. cigna-cnf389Multiple Sclerosis (Injectable - CD20-Directed Cytolytic Antibody) - Kesimpta Prior…
  914. cigna-cnf390Somatostatin Analogs - Mycapssa Prior Authorization
  915. cigna-cnf391Hemophilia - Non-Factor Routine Prophylaxis Products - Hemlibra Prior Authorization Policy
  916. cigna-cnf392Hepatitis C - Epclusa Prior Authorization Policy
  917. cigna-cnf393Hepatitis C - Harvoni Prior Authorization Policy
  918. cigna-cnf394Hepatitis C - Mavyret Prior Authorization Policy
  919. cigna-cnf396Antivirals – Ribavirin (Oral Products) - Prior Authorization
  920. cigna-cnf397Hepatitis C - Sovaldi Prior Authorization Policy
  921. cigna-cnf398Hepatitis C - Viekira Pak™ (ombitasvir/paritaprevir/ritonavir tablets; dasabuvir tablets…
  922. cigna-cnf399Hepatitis C - Vosevi Prior Authorization Policy
  923. cigna-cnf400Hepatitis C - Zepatier Prior Authorization Policy
  924. cigna-cnf401Hepatology - Ocaliva® (obeticholic acid tablets) - Prior Authorization
  925. cigna-cnf403Hereditary Angioedema - C1 Esterase Inhibitors (Subcutaneous) - Haegarda® (C1 esterase…
  926. cigna-cnf404Hereditary Angioedema - Icatibant - Prior Authorization
  927. cigna-cnf406Hereditary Angioedema - Takhzyro™ (lanadelumab-flyo for subcutaneous injection) - Prior…
  928. cigna-cnf407Tasimelteon Products Prior Authorization Policy
  929. cigna-cnf408Homozygous Familial Hypercholesterolemia - Juxtapid Prior Authorization Policy
  930. cigna-cnf409Human Immunodeficiency Virus - Rukobia™ (fostemsavir extended-release tablets) - Prior…
  931. cigna-cnf410Hyperlipidemia - Nexletol Prior Authorization Policy
  932. cigna-cnf411Hyperlipidemia - Nexlizet Prior Authorization Policy
  933. cigna-cnf412Hyperlipidemia - Omega-3 Fatty Acid Products - Prior Authorization
  934. cigna-cnf413Hypoactive Sexual Desire Disorder - Addyi™ (flibanserin tablets) - Prior Authorization
  935. cigna-cnf414Hypoactive Sexual Desire Disorder - Vyleesi™ (bremelanotide subcutaneous injection)…
  936. cigna-cnf415Idiopathic Pulmonary Fibrosis and Related Lung Disease - Pirfenidone Prior Authorization…
  937. cigna-cnf416Idiopathic Pulmonary Fibrosis and Related Lung Disease - Ofev Prior Authorization Policy
  938. cigna-cnf417Gonadotropin-Releasing Hormone Agonist - Synarel® (nafarelin acetate nasal solution)…
  939. cigna-cnf418Oncology - Koselugo Prior Authorization Policy
  940. cigna-cnf420Immunologicals - Dupixent Prior Authorization Policy
  941. cigna-cnf421Immunologicals - Fasenra Prior Authorization Policy
  942. cigna-cnf422Immunologicals - Nucala Prior Authorization Policy
  943. cigna-cnf423Immunologicals - Xolair Prior Authorization Policy
  944. cigna-cnf424Infectious Disease - Daraprim® (pyrimethamine tablets) - Prior Authorization
  945. cigna-cnf425Infectious Disease - Pretomanid tablets - Prior Authorization
  946. cigna-cnf427Inflammatory Conditions - Tocilizumab Subcutaneous Products Prior Authorization Policy
  947. cigna-cnf428Inflammatory Conditions - Adalimumab Products Prior Authorization
  948. cigna-cnf429Inflammatory Conditions - Arcalyst Prior Authorization Policy
  949. cigna-cnf430Lupus - Benlysta Subcutaneous Prior Authorization Policy
  950. cigna-cnf431Inflammatory Conditions - Cimzia Prior Authorization Policy
  951. cigna-cnf432Inflammatory Conditions - Cosentyx Subcutaneous Prior Authorization Policy
  952. cigna-cnf434Inflammatory Conditions - Etanercept Products Prior Authorization Policy
  953. cigna-cnf436Inflammatory Conditions - Ilumya Prior Authorization Policy
  954. cigna-cnf438Inflammatory Conditions - Kevzara Prior Authorization Policy
  955. cigna-cnf439Inflammatory Conditions - Kineret Prior Authorization
  956. cigna-cnf440Inflammatory Conditions - Olumiant Prior Authorization Policy
  957. cigna-cnf441Oncology (Oral - Rearranged During Transfection-Targeting Agent) - Gavreto Prior…
  958. cigna-cnf442Inflammatory Conditions - Orencia Subcutaneous Prior Authorization Policy
  959. cigna-cnf443Inflammatory Conditions - Otezla Prior Authorization Policy
  960. cigna-cnf444Inflammatory Conditions - Rinvoq/Rinvoq LQ Prior Authorization Policy
  961. cigna-cnf445Inflammatory Conditions - Siliq Prior Authorization Policy
  962. cigna-cnf446Inflammatory Conditions - Simponi Aria Prior Authorization Policy
  963. cigna-cnf447Inflammatory Conditions - Simponi Subcutaneous Prior Authorization Policy
  964. cigna-cnf448Inflammatory Conditions - Skyrizi Subcutaneous Prior Authorization Policy
  965. cigna-cnf449Inflammatory Conditions - Ustekinumab Intravenous Products Prior Authorization Policy
  966. cigna-cnf450Inflammatory Conditions - Ustekinumab Subcutaneous Products Prior Authorization Policy…
  967. cigna-cnf451Inflammatory Conditions - Taltz Prior Authorization Policy
  968. cigna-cnf452Inflammatory Conditions - Tremfya Subcutaneous Prior Authorization Policy
  969. cigna-cnf453Inflammatory Conditions - Xeljanz/Xeljanz XR Prior Authorization Policy
  970. cigna-cnf454Interferon - Actimmune Prior Authorization Policy
  971. cigna-cnf455Dichlorphenamide Prior Authorization Policy
  972. cigna-cnf456Lidocaine Patch - Prior Authorization
  973. cigna-cnf457Lipodystrophy - Egrifta Prior Authorization Policy
  974. cigna-cnf458Lofexidine Prior Authorization Policy
  975. cigna-cnf459Neurology - Lyrica CR Prior Authorization with Step Therapy Policy
  976. cigna-cnf460Metabolic Disorders - Carbaglu (carglumic acid tablets for oral suspension) - Prior…
  977. cigna-cnf461Metabolic Disorders - Cysteamine Ophthalmic Solution Prior Authorization Policy
  978. cigna-cnf463Metabolic Disorders - Dojolvi Prior Authorization Policy
  979. cigna-cnf464Metabolic Disorders - Nitisinone Products Prior Authorization Policy
  980. cigna-cnf465Metabolic Disorders - Phenylbutyrate Products Prior Authorization Policy
  981. cigna-cnf466Metabolic Disorders - Tiopronin Products Prior Authorization Policy
  982. cigna-cnf467Metabolic Disorders - Xuriden Prior Authorization Policy
  983. cigna-cnf468Methylergonovine Prior Authorization Policy
  984. cigna-cnf469Migraine - Nurtec ODT Prior Authorization Policy
  985. cigna-cnf470Migraine - Reyvow Prior Authorization Policy
  986. cigna-cnf471Migraine - Ubrelvy™ (ubrogepant tablet) - Prior Authorization
  987. cigna-cnf472Multiple Sclerosis - Dalfampridine Prior Authorization Policy
  988. cigna-cnf473Multiple Sclerosis (Oral - Other) - Teriflunomide Prior Authorization Policy
  989. cigna-cnf474Multiple Sclerosis (Injectable - Beta Interferon) - Avonex Prior Authorization Policy
  990. cigna-cnf475Multiple Sclerosis (Oral - Fumarate) - Bafiertam Prior Authorization Policy
  991. cigna-cnf476Multiple Sclerosis (Injectable - Beta Interferon) - Betaseron Prior Authorization Policy
  992. cigna-cnf477Multiple Sclerosis (Oral - Sphingosine 1-Phosphate Receptor Modulator) - Fingolimod Prior…
  993. cigna-cnf478Multiple Sclerosis (Injectable) - Glatiramer Products Prior Authorization Policy
  994. cigna-cnf479Multiple Sclerosis (Oral - Other) - Mavenclad Prior Authorization Policy
  995. cigna-cnf480Multiple Sclerosis (Oral - Sphingosine 1-Phosphate Receptor Modulator) - Mayzent Prior…
  996. cigna-cnf481Multiple Sclerosis (Injectable - Beta Interferon) - Plegridy Prior Authorization Policy
  997. cigna-cnf482Multiple Sclerosis (Injectable - Beta Interferon) - Rebif Prior Authorization Policy
  998. cigna-cnf483Multiple Sclerosis (Oral - Fumarate) - Dimethyl Fumarate Prior Authorization Policy
  999. cigna-cnf484Multiple Sclerosis (Oral - Fumarate) - Vumerity Prior Authorization Policy
  1000. cigna-cnf485Multiple Sclerosis and Ulcerative Colitis (Oral - Sphingosine 1-Phosphate Receptor…

About this dataset

Insurer clinical and medical policies state when a payer covers a device, drug or procedure. Orca1 links each policy to the FDA submissions, trials and articles it cites. Policy text is not reproduced here.

Source: Health insurer clinical and medical policies (insurer as listed); cross-links by Orca1