Anthem Blue Cross and Blue Shield New Hampshire prior authorization B4189

Anthem Blue Cross and Blue Shield New Hampshire prior authorization for B4189: Parenteral nutrition solution: compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, 10 to 51 g of protein, premix

Code: B4189
Description: Parenteral nutrition solution: compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, 10 to 51 g of protein, premix
Source: New Hampshire Precertification List, Pg 209 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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