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ECHO PROGRAM The Extended Care Health Option ECHO provides financial assistance to beneficiaries with special needs for an integrated set of services and supplies These supplies can include a wide variety of speciality and custom built durable medical equipment that can serve as a monumental aid to daily living for your patients Enrollment info benefits and additional information for ECHO covered services and supplies can be found at www Tricare mil CORPORATE OFFICE 1170 1172 N Knollwood Circle Anaheim CA 92801 800 270 6990 Fax 800 497 8856 NPI 1942392527 ARIZONA BRANCH 1050 N Fairway Drive Suite B 106 Avondale AZ 85323 623 248 1630 Fax 623 248 1701 NPI 1366008161 Tomato Jogger Hi low chair COLORADO BRANCH 1039 Elkton Dr Garden of the Gods Colorado Springs CO 80907 719 413 5090 Fax 719 413 5089 NPI 1174137731 HAWAII BRANCH Diapers 3049 Ualena Street Unit 101 First Floor Honolulu HI 96819 1942 808 691 9973 Fax 888 286 7412 NPI 1205354321 WASHINGTON BRANCH 5009 Paci c Hwy East Ste 7 Fife WA 98424 253 235 5840 Fax 253 344 1457 NPI 1669040465 Tax ID 74 3042082 Hygiene Toileting System The ECHO program covers a wide variety of products specific to your child s needs Please call us at 800 270 6990 to discuss further www MilitaryMedical US com PEDIATRIC DURABLE MEDICAL EQUIPMENT APPROVED Nationwide Provider
TRICARE COVERED BENEFITS Cane ENTERAL FEEDING Walker Amino Based Knee Walker Hypoallergenic Wheelchair Dairy Alternative Toddler Premature More options available Nebulizers that are fun to use START ORDERING TODAY TRICARE WEST 1 Fax your prescription to our local office 2 Bed Wetting Alarm Eye Patches 3 numbers on back panel We verify insurance and submit for Tricare authorization Once approved we personally deliver or expedite shipping via FedEx UPS or USPS TRICARE EAST 1 Patient will need to contact PCM to submit 2 Haberman Bottle A oVest Scan QR code or visit our website www MilitaryMedical US com pediatrics for more products 3 for approval Our NPI 1942392527 will need to be provided for submission Once approved we personally deliver or expedite shipping via FedEx UPS or USPS THAT S IT No authorization is required for TriCare Select BENEFIT REQUIREMENTS 1 Approved when prescribed for dietary management of a covered disease Medical necessity is required 2 Doctor recommended caloric consumption per day 3 Clinical notes supporting diagnosis sent with prescription 4 Recommended preferred type If unknown we can recommend an option 5 Not all formulas are covered REPLENISHMENT RESUPPLY Some products require periodic replenishment Per your order and TriCare approval we contact the parent or guardian each month to verify the product is still used and needed We NEVER auto ship Any request to adjust dosage will be deferred to you Quality patient care is our top priority