J3401 prior authorization | Anthem Blue Cross and Blue Shield Virginia

J3401, Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml, is on the Anthem Blue Cross and Blue Shield Virginia HMO/EPO prior authorization list. Not a coverage or referral decision.

Code: J3401
Description: Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml
Source: Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 70 Original policy

Anthem Blue Cross and Blue Shield Virginia prior authorization

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