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What this means in practice: A prescription for "type 2 diabetes management" with weight loss as a secondary benefit: covered A prescription for "obesity treatment" in a patient who also has diabetes: excluded A prescription with both diagnosis codes (E11.9 and E66.01) where diabetes is listed first: usually covered, sometimes flagged for review A prescription with obesity as the primary diagnosis: excluded Medicare's pharmacy benefit managers (PBMs) audit claims and medical records