Cequa — Medical Mutual
Dry Eye Conditions due to Systemic Inflammatory Disease (e.g. Sjogren’s Syndrome, rheumatoid arthritis, Systemic Lupus Erythematosus)
Initial criteria
- Patient age ≥ 18 years
- Medication is prescribed by or in consultation with an ophthalmologist, optometrist, or rheumatologist
Reauthorization criteria
- Patient age ≥ 18 years
- Medication is prescribed by or in consultation with an ophthalmologist, optometrist, or rheumatologist
Approval duration
1 year initial, 1 year reauth