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J1576 prior authorization | Anthem Blue Cross Blue Shield of California

J1576: Immune Globulin (Human) IV (Panzyga). 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.

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Code
J1576
Description
Immune Globulin (Human) IV (Panzyga)
Source
California PPO Prior Authorization List, Pg 189 Original policy

Anthem Blue Cross Blue Shield of California prior authorization

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