0515U prior authorization | Blue Shield of California Promise Health Plan

0515U, Gastroenterology (irritable bowel disease [ibd]), immunoassay for quantitative determination of infliximab (ifx) levels in venous serum in patients undergoing infliximab therapy, results reported as a numerical value as micrograms per milliliter (g/ml), is on the Blue Shield of California Promise Health Plan Medi-Cal prior authorization list. Not a coverage or referral decision.

Code: 0515U
Description: Gastroenterology (irritable bowel disease [ibd]), immunoassay for quantitative determination of infliximab (ifx) levels in venous serum in patients undergoing infliximab therapy, results reported as a numerical value as micrograms per milliliter (g/ml)
Source: Medi-Cal Prior Authorization List, Pg 17 Original policy

Blue Shield of California Promise Health Plan prior authorization

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