J1553 prior authorization | Anthem Blue Cross Blue Shield of California

J1553: Immune globulin intravenous, human-dira (Yimmugo). Imported Anthem Blue Cross Blue Shield of California PPO source reference; confirm plan-specific review requirements in the original document. Not a coverage or referral decision.

Code

J1553

Description

Immune globulin intravenous, human-dira (Yimmugo)

Source

California PPO Prior Authorization List, Pg 189 Original policy

Anthem Blue Cross Blue Shield of California prior authorization