J7204 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

J7204, Injection, Factor VIII, antihemophilic factor (recombinant), (Esperoct), glycopegylated-exei, per IU, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: J7204
Description: Injection, Factor VIII, antihemophilic factor (recombinant), (Esperoct), glycopegylated-exei, per IU
Source: New Hampshire Precertification List, Pg 242 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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