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201905-117020
2019
Excellus
PPO
Gynecological
Pharmacy/ Prescription Drugs
Medical necessity
Overturned
Case Summary
Diagnosis: Obesity, Polycystic ovary syndrome
Treatment: Saxenda
Summary:
In this case the patient is a woman with a current BMI (body mass index) of 36.7 kg/m2 comorbid health conditions of PCOS (polycystic ovary syndrome). Initiation of Saxenda is medically necessary per FDA prescribing information and would be expected to be health beneficial for this patient in conjunction with a reduced calorie diet and exercise program.
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