Florida Blue policy

Medical Pharmacy PA/UM Drug List

Medical Pharmacy PA/UM Drug List is a public Florida Blue policy. It lists 602 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.

View the original policy (PDF) ↗

Payer
Florida Blue
Line of business
Commercial
Source
files.guidewell.com

Codes in this policy

The CPT and HCPCS codes the policy names. A policy can name a code it excludes.

CodeOther Florida Blue policies
67028Policies naming 67028
90281Policies naming 90281
90283Policies naming 90283
90284Policies naming 90284
90378Policies naming 90378
90399Policies naming 90399
96413Policies naming 96413
A9156Policies naming A9156
A9513Policies naming A9513
A9543Policies naming A9543
A9590Policies naming A9590
A9600Policies naming A9600
A9604Policies naming A9604
A9606Policies naming A9606
A9607Policies naming A9607
A9699Policies naming A9699
C9047Policies naming C9047
C9174Policies naming C9174
C9257Policies naming C9257
C9302Policies naming C9302
C9305Policies naming C9305
C9306Policies naming C9306
C9307Policies naming C9307
C9308Policies naming C9308
C9399Policies naming C9399
G0138Policies naming G0138
J0013Policies naming J0013
J0129Policies naming J0129
J0139Policies naming J0139
J0172Policies naming J0172
J0174Policies naming J0174
J0175Policies naming J0175
J0177Policies naming J0177
J0178Policies naming J0178
J0179Policies naming J0179
J0180Policies naming J0180
J0185Policies naming J0185
J0202Policies naming J0202
J0208Policies naming J0208
J0215Policies naming J0215
J0217Policies naming J0217
J0218Policies naming J0218
J0219Policies naming J0219
J0220Policies naming J0220
J0221Policies naming J0221
J0222Policies naming J0222
J0223Policies naming J0223
J0224Policies naming J0224
J0225Policies naming J0225
J0256Policies naming J0256
J0257Policies naming J0257
J0364Policies naming J0364
J0470Policies naming J0470
J0490Policies naming J0490
J0491Policies naming J0491
J0517Policies naming J0517
J0565Policies naming J0565
J0567Policies naming J0567
J0570Policies naming J0570
J0577Policies naming J0577
J0578Policies naming J0578
J0584Policies naming J0584
J0585Policies naming J0585
J0586Policies naming J0586
J0587Policies naming J0587
J0588Policies naming J0588
J0589Policies naming J0589
J0591Policies naming J0591
J0593Policies naming J0593
J0596Policies naming J0596
J0597Policies naming J0597
J0598Policies naming J0598
J0599Policies naming J0599
J0600Policies naming J0600
J0601Policies naming J0601
J0602Policies naming J0602
J0603Policies naming J0603
J0605Policies naming J0605
J0607Policies naming J0607
J0608Policies naming J0608
J0609Policies naming J0609
J0615Policies naming J0615
J0638Policies naming J0638
J0641Policies naming J0641
J0642Policies naming J0642
J0717Policies naming J0717
J0725Policies naming J0725
J0738Policies naming J0738
J0752Policies naming J0752
J0775Policies naming J0775
J0791Policies naming J0791
J0799Policies naming J0799
J0801Policies naming J0801
J0802Policies naming J0802
J0870Policies naming J0870
J0879Policies naming J0879
J0881Policies naming J0881
J0882Policies naming J0882
J0885Policies naming J0885
J0886Policies naming J0886
J0887Policies naming J0887
J0888Policies naming J0888
J0889Policies naming J0889
J0896Policies naming J0896
J0897Policies naming J0897
J0901Policies naming J0901
J1071Policies naming J1071
J1072Policies naming J1072
J1073Policies naming J1073
J1201Policies naming J1201
J1202Policies naming J1202
J1203Policies naming J1203
J1246Policies naming J1246
J1290Policies naming J1290
J1299Policies naming J1299
J1301Policies naming J1301
J1302Policies naming J1302
J1303Policies naming J1303
J1304Policies naming J1304
J1305Policies naming J1305
J1306Policies naming J1306
J1307Policies naming J1307
J1322Policies naming J1322
J1323Policies naming J1323
J1325Policies naming J1325
J1326Policies naming J1326
J1411Policies naming J1411
J1412Policies naming J1412
J1413Policies naming J1413
J1414Policies naming J1414
J1426Policies naming J1426
J1427Policies naming J1427
J1428Policies naming J1428
J1429Policies naming J1429
J1434Policies naming J1434
J1437Policies naming J1437
J1438Policies naming J1438
J1439Policies naming J1439
J1440Policies naming J1440
J1442Policies naming J1442
J1445Policies naming J1445
J1447Policies naming J1447
J1448Policies naming J1448
J1449Policies naming J1449
J1453Policies naming J1453
J1454Policies naming J1454
J1458Policies naming J1458
J1459Policies naming J1459
J1551Policies naming J1551
J1552Policies naming J1552
J1554Policies naming J1554
J1555Policies naming J1555
J1556Policies naming J1556
J1557Policies naming J1557
J1558Policies naming J1558
J1559Policies naming J1559
J1561Policies naming J1561
J1562Policies naming J1562
J1566Policies naming J1566
J1568Policies naming J1568
J1569Policies naming J1569
J1572Policies naming J1572
J1575Policies naming J1575
J1576Policies naming J1576
J1595Policies naming J1595
J1599Policies naming J1599
J1602Policies naming J1602
J1627Policies naming J1627
J1628Policies naming J1628
J1632Policies naming J1632
J1645Policies naming J1645
J1650Policies naming J1650
J1652Policies naming J1652
J1726Policies naming J1726
J1729Policies naming J1729
J1740Policies naming J1740
J1743Policies naming J1743
J1744Policies naming J1744
J1745Policies naming J1745
J1747Policies naming J1747
J1748Policies naming J1748
J1786Policies naming J1786
J1809Policies naming J1809
J1823Policies naming J1823
J1826Policies naming J1826
J1830Policies naming J1830
J1930Policies naming J1930
J1931Policies naming J1931
J1932Policies naming J1932
J1941Policies naming J1941
J1950Policies naming J1950
J1951Policies naming J1951
J1952Policies naming J1952
J1954Policies naming J1954
J2170Policies naming J2170
J2182Policies naming J2182
J2212Policies naming J2212
J2267Policies naming J2267
J2277Policies naming J2277
J2315Policies naming J2315
J2323Policies naming J2323
J2326Policies naming J2326
J2327Policies naming J2327
J2329Policies naming J2329
J2350Policies naming J2350
J2351Policies naming J2351
J2353Policies naming J2353
J2355Policies naming J2355
J2356Policies naming J2356
J2357Policies naming J2357
J2468Policies naming J2468
J2469Policies naming J2469
J2502Policies naming J2502
J2503Policies naming J2503
J2506Policies naming J2506
J2507Policies naming J2507
J2508Policies naming J2508
J2562Policies naming J2562
J2675Policies naming J2675
J2724Policies naming J2724
J2777Policies naming J2777
J2778Policies naming J2778
J2779Policies naming J2779
J2781Policies naming J2781
J2782Policies naming J2782
J2783Policies naming J2783
J2786Policies naming J2786
J2787Policies naming J2787
J2788Policies naming J2788
J2790Policies naming J2790
J2791Policies naming J2791
J2792Policies naming J2792
J2793Policies naming J2793
J2797Policies naming J2797
J2802Policies naming J2802
J2820Policies naming J2820
J2840Policies naming J2840
J2860Policies naming J2860
J2941Policies naming J2941
J2998Policies naming J2998
J3031Policies naming J3031
J3032Policies naming J3032
J3055Policies naming J3055
J3060Policies naming J3060
J3110Policies naming J3110
J3111Policies naming J3111
J3121Policies naming J3121
J3145Policies naming J3145
J3241Policies naming J3241
J3245Policies naming J3245
J3247Policies naming J3247
J3262Policies naming J3262
J3263Policies naming J3263
J3285Policies naming J3285
J3299Policies naming J3299
J3304Policies naming J3304
J3315Policies naming J3315
J3316Policies naming J3316
J3355Policies naming J3355
J3357Policies naming J3357
J3358Policies naming J3358
J3380Policies naming J3380
J3385Policies naming J3385
J3387Policies naming J3387
J3389Policies naming J3389
J3391Policies naming J3391
J3392Policies naming J3392
J3393Policies naming J3393
J3394Policies naming J3394
J3396Policies naming J3396
J3397Policies naming J3397
J3398Policies naming J3398
J3399Policies naming J3399
J3401Policies naming J3401
J3402Policies naming J3402
J3403Policies naming J3403
J3420Policies naming J3420
J3489Policies naming J3489
J3490Policies naming J3490
J3520Policies naming J3520
J3535Policies naming J3535
J3590Policies naming J3590
J3591Policies naming J3591
J7170Policies naming J7170
J7171Policies naming J7171
J7172Policies naming J7172
J7173Policies naming J7173
J7174Policies naming J7174
J7175Policies naming J7175
J7177Policies naming J7177
J7178Policies naming J7178
J7179Policies naming J7179
J7180Policies naming J7180
J7181Policies naming J7181
J7182Policies naming J7182
J7183Policies naming J7183
J7185Policies naming J7185
J7186Policies naming J7186
J7187Policies naming J7187
J7188Policies naming J7188

And 302 more in the original policy.

All Florida Blue policies

Disclaimer

The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

Substrate makes no representation or warranty regarding the accuracy, completeness, or timeliness of the payor-specific information presented here. Providers are solely responsible for ensuring that all claims are submitted in accordance with applicable payor requirements, and Substrate assumes no liability for claim denials, underpayments, or other adverse outcomes arising from reliance on this information.