机构名称：
¥ 1.0
• Air Ambulance – Non-emergency (no benefit without prior authorization) • Applied Behavior Analysis** • Arterial Ultrasound* • Arthroscopy and Open Procedures (shoulder & knee)* • Bone Growth Stimulator • Cardiac Rehabilitation • Cellular Immunotherapy (no benefit without written authorization) • Coronary Arteriography* • CT Scans* • Day Rehabilitation Programs • Durable Medical Equipment (greater than $300) • Electric & Custom Wheelchairs • Gene Therapy (no benefit without written authorization) • Genetic and Molecular Testing* • Hearing Aids age 18 & older (no benefit without prior authorization) • Hip Arthroscopy* • Home Health Care • Hospice • Hyperbarics • Implantable Medical Devices over $2,000 (including but not limited to defibrillators) • Infusion Therapy – includes home and facility administration (exception: not required when performed in an office, the drug to be infused may require授权）•住院医院服务（例行产妇停留除外）•密集的门诊计划**•介入的脊柱疼痛管理*•关节置换（臀部，膝盖和肩膀）*•低蛋白食品•半月掩膜术•膝关节同种异体移植膝关节移植*
BlueHPN网络速度指南
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