| SERIAL NUMBER | Procedure | 1st Qtr | Per Qtr (for next 3 Qtrs) | Requirements while submitting for follow-up Preauth | Requirements while submitting for follow-up Claims |
|---|---|---|---|---|---|
| 84 | FP0084 : Steroid Resistant Nephrotic syndrome Complicated ro Resistant | 2,000 | 1,000 | Previous Discharge Summary | (RFT, Clinical Evaluation, USG-Mandatory), Urine Analysis |
| 90 | FP0090 : Nephrotic Syndrome | 2,000 | 1,000 | Previous Discharge Summary | (Clinical Evaluation, RFT, Urine Analysis-Mandatory)/USG 3rd Quarter |
