Anthem Blue Cross and Blue Shield Virginia prior authorization A2004

Anthem Blue Cross and Blue Shield Virginia prior authorization for A2004: Xcellistem, 1 mg/Original description: Miscellaneous with Motor <27.85, without comorbidities,10/2019 description: Miscellaneous M <46.50 and A >=77.50.,witho

Code: A2004
Description: Xcellistem, 1 mg/Original description: Miscellaneous with Motor <27.85, without comorbidities,10/2019 description: Miscellaneous M <46.50 and A >=77.50.,witho
Source: Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 60 Original policy

Anthem Blue Cross and Blue Shield Virginia prior authorization

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