J3401 prior authorization | Anthem Blue Cross Blue Shield of Georgia

J3401, Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 109 PFU/ml vector genomes, per 0.1 ml, is on the Anthem Blue Cross Blue Shield of Georgia prior authorization list. Not a coverage or referral decision.

Code: J3401
Description: Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 109 PFU/ml vector genomes, per 0.1 ml
Source: Standard Local Prior Authorization Code List, Pg 122 Original policy

Anthem Blue Cross Blue Shield of Georgia prior authorization

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