Anthem Blue Cross and Blue Shield New Hampshire prior authorization Q2058
Anthem Blue Cross and Blue Shield New Hampshire prior authorization for Q2058: Obecabtagene autoleucel, 10 up to 400 million CD19 CAR-positive viable T cells, including leukapheresis and dose preparation procedures, per infusion
- Code
- Q2058
- Description
- Obecabtagene autoleucel, 10 up to 400 million CD19 CAR-positive viable T cells, including leukapheresis and dose preparation procedures, per infusion
- Source
- New Hampshire Precertification List, Pg 254 Original policy
Anthem Blue Cross and Blue Shield New Hampshire prior authorization