Anthem Blue Cross and Blue Shield Virginia prior authorization J3401

Anthem Blue Cross and Blue Shield Virginia prior authorization for J3401: Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml

Code: J3401
Description: Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml
Source: Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 70 Original policy

Anthem Blue Cross and Blue Shield Virginia prior authorization

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