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City Washington / Compensator / / Company Jaw Motion Rehab Systems / PET / / Facility Facility Based Sleep Studies / Hospital Beds / / IndustryTerm posterior spinous process distraction device / prosthetic devices / stimulator devices / bone cement / traction devices / closure devices / thermal energy / prognostic algorithm / imaging / implantable device / maternity-related services / mechanical device / ventricular assist device / carotid sinus baroreflex activation device / chemical peels/abrasions / post-processing / high energy / carotid intima-media thickness / / MedicalCondition scar / fresh hepatocellular carcinoma tumor / coronary heart disease / Description Scoliosis / gynecomastia / prophylactic mastectomy / gastrointestinal neuroendocrine tumors / Upper Gastrointestinal Endoscopy Varicose Veins / Tumors / fecal incontinence / catheter-delivered prosthetic pulmonary valve / pain / sleep apnea / rectal tumor / morbid obesity / / MedicalTreatment Radiation Therapy / Deep Brain stimulation / orthopedic procedure / Spine surgeries / Breast Surgeries / reconstructive surgery / stereotactic radiosurgery / surgery / radiation / liposuction / heart transplants / Hysterectomy / catheter / Hyperbaric Oxygen Therapy / mammoplasty / chemical peels / liver transplants / Abdominoplasty / cell therapy / face lifts / Vertebroplasty / eyelid surgery / spinal surgery / mastectomy / TENS / / Organization American Society of Anesthesiologists / / Person Cimzia (Certolizumab) Erbitux / Vectibix (Panitumumab) Xolair / Amevive (Alefacept) Avastin / Actemra (Tocilizumab) Amevive / Receptor Inhibitors Herceptin / Synagis (Palivizumab) Vectibix / Wound Healing Remicade (Infliximab) / Physical / Lucentis (Ranibizumab) Macugen / Avastin (Bevacizumab) Benlysta / Stelara (Ustekinumab) Synagis / Rituxan (Rituximab) Stelara / / / Position report Pre Operative / operative report Pre-Service Review Recommended Medical Necessity Pre Operative / Pre-Service Review Recommended Medical Necessity Pre Operative / physician / Authorization Required Investigative Pre Operative / medical necessity Pre Operative / Operative report Pre Operative / procedure report Investigative Pre Operative / customer service representative / Operative / / Product Synagis / Herceptin / Remodulin / Rituxan / Amevive / Aranesp / Flolan / Macugen / Remicade / Avastin / Lucentis / Bexxar / Mylotarg / Orencia / Vectibix / Zevalin / Erbitux / Xolair / / PublishedMedium BIS / Magnetic Resonance Imaging / the Clinical Review / / Technology alpha / Radiation / Cell Therapy / Tomography / ultrasound / MRI / Magnetic Resonance Imaging / Spectroscopy / / URL www.premera.com/wa/provide / / SocialTag 
Clinical Review by Code List LWWA