Anthem Blue Cross Blue Shield of California prior authorization 0474T

Anthem Blue Cross Blue Shield of California prior authorization for 0474T: Insertion of anterior segment aqueous drainage device, with creation of intraocular reservoir, internal approach, into the supraciliary space; each additional device [XEN Gel Stent]

Code: 0474T
Description: Insertion of anterior segment aqueous drainage device, with creation of intraocular reservoir, internal approach, into the supraciliary space; each additional device [XEN Gel Stent]
Source: California PPO Prior Authorization List, Pg 52 Original policy

Anthem Blue Cross Blue Shield of California prior authorization

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