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As for, the SBP-lowering mechanisms of DPP-4 inhibitor may complement or augment SGLT2 inhibitor-induced plasma volume reduction and other mechanism

Common gaps in initial submissions: Detailed diet and exercise log covering at least 12 weeks Documentation of supervised weight loss attempts (dietitian visits, weight management program enrollment) Lab work showing obesity-related metabolic abnormalities (elevated HbA1c, lipid panel, liver enzymes) Sleep study confirming obstructive sleep apnea Imaging or clinical notes documenting osteoarthritis or other mechanical complications of obesity Step 3: Physician letter of medical necessity

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