CommercialMay 1, 2022
Anthem clinical criteria updates for specialty pharmacy are available
Effective for dates of service on and after August 1, 2022, the following current clinical criteria were revised and might result in services that were previously covered but may now be found to be not medically necessary.
Access the clinical criteria document information.
Anthem’s prior authorization clinical review of non-oncology specialty pharmacy drugs will be managed by Anthem’s medical specialty drug review team. Drugs used for the treatment of Oncology will be managed by AIM Specialty Health® (AIM).
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ING-CC-0033 |
Xolair (omalizumab) |
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ING-CC-0042 |
Monoclonal Antibodies to Interleukin-17 |
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ING-CC-0050 |
Monoclonal Antibodies to Interleukin-23 |
|
ING-CC-0124 |
Keytruda (pembrolizumab) |
|
ING-CC-0186 |
Margenza (margetuximab-cmkb) |
|
ING-CC-0209 |
Leqvio (inclisiran) |
|
ING-CC-0210 |
Enjaymo (sutimlimab-jome) |
|
ING-CC-0212 |
Tezspire (tezepelumab-ekko) |
|
ING-CC-0213 |
Voxzogo (vosoritide) |
PUBLICATIONS: May 2022 Anthem Provider News - Georgia
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