Georgia
Provider Communications
Clinical Criteria updates for specialty pharmacy are available
ING-CC-0068 |
Growth hormone |
ING-CC-0087 |
Gamifant (emapalumab) |
ING-CC-0107 |
Bevacizumab for non-ophthalmologic indications |
ING-CC-0118 |
Radioimmunotherapy and somatostatin receptor targeted radiotherapy (Azedra, Lutathera, Pluvicto, Zevalin) |
ING-CC-0119 |
Yervoy (ipilimumab) |
ING-CC-0124 |
Keytruda (pembrolizumab) |
ING-CC-0153 |
Adakveo (crizanlizumab) |
ING-CC-0215 |
Ketamine injection (Ketalar) |
ING-CC-0216 |
Opdualag (nivolumab and relatlimab-rmbw) |
Access the Clinical Criteria document information.
Prior authorization clinical review of non-oncology specialty pharmacy drugs will be managed by the Medical Specialty Drug Review team for Anthem Blue Cross and Blue Shield. Drugs used for the treatment of oncology will be managed by AIM Specialty Health® (AIM).*
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August 2022 Anthem Provider News - Georgia