S0013 prior authorization | Anthem Blue Cross and Blue Shield Nevada

S0013: Esketamine, nasal spray, 1 mg. Imported Anthem Blue Cross and Blue Shield Nevada source reference; confirm plan-specific review requirements in the original document. Not a coverage or referral decision.

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Code: S0013
Description: Esketamine, nasal spray, 1 mg
Source: Nevada Prior Authorization List, Pg 168 Original policy

Anthem Blue Cross and Blue Shield Nevada prior authorization

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