S0189 prior authorization | Anthem Blue Cross Blue Shield of Colorado

S0189: Testosterone pellet, 75 mg. Imported Anthem Blue Cross Blue Shield of Colorado source reference; confirm plan-specific review requirements in the original document. Not a coverage or referral decision.

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We'll verify benefits and check if CPT Code S0189 is identified as requiring a prior authorization

Code: S0189
Description: Testosterone pellet, 75 mg
Source: Colorado Prior Authorization List, Pg 175 Original policy

Anthem Blue Cross Blue Shield of Colorado prior authorization

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