- Mycosis Fungoides and Other Cutaneous T-Cell . . . - Cigna Healthcare
Clinical Presentation Cutaneous T-cell lymphomas, which include mycosis fungoides and Sézary syndrome, are neoplasias of malignant T lymphocytes that usually possess the helper inducer cell surface phenotype and initially present as skin involvement [ 1] Cutaneous T-cell lymphomas should be distinguished from other
- Prior Authorization Criteria - Cigna Healthcare
Prior Authorization Criteria 2025 Saver PDP 5 Tier Last Updated: 11 1 2025
- 2025 MAPD Standard 5 Tier - Cigna Healthcare
Obstructive hypertrophic cardiomyopathy, initial-Approve if the pt meets the following criteria (i, ii and iii): i Pt meets both of the following (a and b): a)Pt has at least 1 symptom associated w obstructive hypertrophic cardiomyopathy (Note: examples include shortness of breath, chest pain, lightheadedness, fainting, fatigue, and reduced ability to perform physical exercise), AND b)Pt has
- 2025 EGWP Enhanced 4 Tier - Cigna Healthcare
Prior Authorization Criteria 2025 EGWP Enhanced 4 Tier Last Updated:10 1 2025
- GB ACS5T CMP Without DS STD 2025 - Cigna Healthcare
Prior Authorization Criteria 2025 Premier Access Last Updated: 11 1 2025
- 2024 PDP Secure 5 Tier - Cigna Healthcare
Prior Authorization Criteria 2024 Secure PDP 5 Tier Last Updated: 12 1 2024
- GB STD ACS Comp 2024 - Cigna Healthcare
Prior Authorization Criteria 2024 Premier Access Last Updated: 12 1 2024
- 2024 MAPD Standard 5 Tier - Cigna Healthcare
gentamicin in nacl (iso-osm) intravenous piggyback 100 mg 100 ml, 100 mg 50 ml, 120 mg 100 ml, 60 mg 50 ml, 80 mg 100 ml, 80 mg 50 ml
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