Medical Policy

Radiation Treatment with Lutathera

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Radiofrequency Ablation (RFA) and Cryosurgery of Primary or Metastatic Liver Tumors

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Radiofrequency Ablation of Miscellaneous Solid Tumors Excluding Liver Tumors

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Radiofrequency Facet Denervation

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Ramucirumab (Cyramza®)

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Recombinant and Autologous Platelet-Derived Growth Factors for Wound Healing and Other Non‒Orthopedic Conditions

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Removal of Benign or Premalignant Skin Lesions

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Respiratory Assist Devices

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Responsive Neurostimulation for the Treatment of Refractory Partial Epilepsy

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Rituximab (Rituxan, Truxima) and Rituximab and Hyaluronidase Human (Rituxan Hycela)

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romiplostim (Nplate)

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Romosozumab-aqqg (Evenity)

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