Medicare AdvantageMarch 1, 2019
Clinical criteria updates for specialty pharmacy
The following revised clinical criteria will be effective May 1, 2019. Visit www.anthem.com/pharmacyinformation/clinicalcriteria to search for specific clinical criteria. Please share this notice with other members of your practice and office staff.
Clinical criteria effective date |
Clinical criteria number |
Clinical criteria |
Clinical criteria (new/revised) |
May 1, 2019 |
ING-CC-0001 |
Erythropoiesis Stimulating Agents |
Revised |
May 1, 2019 |
ING-CC-0004 |
H.P. Acthar Gel® (repository corticotropin injection) |
Revised |
May 1, 2019 |
ING-CC-0072 |
Selective Vascular Endothelial Growth Factor (VEGF) Antagonists |
Revised |
75743MUPENMUB 01/24/2019
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