90378 prior authorization | Anthem Blue Cross and Blue Shield Virginia

90378, Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each, is on the Anthem Blue Cross and Blue Shield Virginia HMO/EPO prior authorization list. Not a coverage or referral decision.

Code: 90378
Description: Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each
Source: Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 57 Original policy

Anthem Blue Cross and Blue Shield Virginia prior authorization

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