Last Published 03.01.2026 Effective Date: 03.01.2026 This policy addresses electrical stimulation for the treatment of pain and muscle rehabilitation, including transcutaneous electrical nerve stimulator (TENS), functional electrical stimulation (FES), and neuromuscular electrical stimulation (NMES)
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CHEMICAL STRUCTURE CAS Number: 910463-68-2 Molecular Formula: C187H291N45O59 Molecular Weight: ~4113.58 g/mol Peptide Sequence: H-Aib-Glu-Gly-Thr-Phe-Thr-Ser-Asp-Val-Ser-Ser-Tyr-Leu-Glu-Gln-Lys-Ala-Ala-Gln-Ala-Ala-Lys-Glu-Phe-Ile-Ala-Trp-Leu-Val-Arg-Gly-Arg-NH
they would have to spend $2,400 on other drugs to hit the cap and get the rest of their drugs for the year at no cost to them
Wegovy is a brand-name prescription drug containing semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist