AETNA HEALTH INC. (CONNECTICUT)Aetna • August 25th, 2009
Precertification Drug(s) ACTHAR HP DIFFERIN- for members greater than 35 years of age ERBITUX GABITRIL phenylephrine/promethazine/codeine- for members less than 6 years of age promethazine/codeine- for members less than 6 years of age RITUXAN TAZORAC- for members greater than 35 years of age TYSABRI VECTIBIX VIMPAT ZONEGRAN zonisamide
AETNA HEALTH INC. (ARIZONA)Aetna • March 3rd, 2015
Covered Dental Services shown below must be given by Participating Dental Providers, at the dental office location, except for Referral Care when approved by HMO; or for Out-Of-Area Emergency Dental Care.
AETNA HEALTH INC. (ARIZONA)Aetna • November 17th, 2020
Contract Holder Name: BNSF Railway Company Contract Holder Group Agreement Effective Date: 727796 Contract Holder Number: January 1, 2021
