0704T prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

0704T, Remote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 0704T
Description: Remote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment
Source: New Hampshire Precertification List, Pg 68 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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