Kentucky | GRAFIX PL Lyopreserved Placental Membrane and GRAFIX Cryopreserved Placental Membrane

Aetna

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United Healthcare

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Humana

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Department of Veterans Affairs Health Plan

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Cigna

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BCBS Federal Employee Plan

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Kentucky Medicaid

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Based on Medical Necessity

CGS Administrators

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Lower Extremity Ulcers

Wellcare (Centene)

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DFU and VLU - Grafix PRIME (Q4133) only

Sierra Health and Life (UHC)

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Follows Active Medicare LCD/LCA

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