Anthem Blue Cross and Blue Shield Virginia prior authorization Q2043

Anthem Blue Cross and Blue Shield Virginia prior authorization for Q2043: Sipuleucel-t, minimum of 50 million autologous cd54+ cells activated with pap-gm-csf, including leukapheresis and all other preparatory procedures, per infusion

Code: Q2043
Description: Sipuleucel-t, minimum of 50 million autologous cd54+ cells activated with pap-gm-csf, including leukapheresis and all other preparatory procedures, per infusion
Source: Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 75 Original policy

Anthem Blue Cross and Blue Shield Virginia prior authorization

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