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Bimatoprost 0.03% ophthalmic solution – generic onlyCigna

Ocular Hypertension

Initial criteria

  • Patient age < 60 years (prior authorization required; age edit applies)
  • FDA-approved indication OR other use with supportive evidence
  • Prescription benefit coverage is not recommended for cosmetic conditions (e.g., eyelash growth)

Approval duration

1 year