Timolol Maleate - Timolol Maleate solution Prior Authorization Resources

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California - Uniform Prior Authorization FormCalifornia
Colorado - Uniform Prior Authorization FormColorado
Illinois - Uniform Prior Authorization FormIllinois
Indiana - Uniform Prior Authorization FormIndiana
Louisiana - Uniform Prior Authorization FormLouisiana
Minnesota - Uniform Prior Authorization FormMinnesota

ICD-10 codes for Timolol Maleate - Timolol Maleate solution Prior Authorizations

H40.051Ocular hypertension, right eye
H40.052Ocular hypertension, left eye
H40.053Ocular hypertension, bilateral
H40.059Ocular hypertension, unspecified eye
H40.10X0Unspecified open-angle glaucoma, stage unspecified
H40.11X0Primary open-angle glaucoma, stage unspecified
H40.1190Primary open-angle glaucoma, unspecified eye, stage unspecified

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