Premera Blue Cross of Washington prior authorization J7686

Premera Blue Cross of Washington prior authorization for J7686: Treprostinil, inhalation solution, FDA- approved final product, noncompounded, administered through DME, unit dose form, 1.74 mg These criteria do not imply or guarantee approval.

Code: J7686
Description: Treprostinil, inhalation solution, FDA- approved final product, noncompounded, administered through DME, unit dose form, 1.74 mg These criteria do not imply or guarantee approval.
Source: Clinical Review by Code List PBCWA, Pg 720 Original policy

Premera Blue Cross of Washington prior authorization

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