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The Policy VaultThe Policy Vault

Qlosi (pilocarpine) 0.4% ophthalmic solution — United Healthcare

Presbyopia

Initial criteria

  • Qlosi or Vuity is not considered medically necessary for the treatment of presbyopia.
  • All requests for authorization will be denied.

Reauthorization criteria

  • Qlosi or Vuity is not considered medically necessary for the treatment of presbyopia.
  • All requests for authorization will be denied.