90380 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

90380, Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 mL dosage, for intramuscular use, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 90380
Description: Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 mL dosage, for intramuscular use
Source: New Hampshire Precertification List, Pg 183 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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