Nevada
Provider Communications
Prior authorization updates for specialty pharmacy -- April
Please note, inclusion of the National Drug Code (NDC) on your claim will help expedite claim processing of drugs billed with a Not Otherwise Classified (NOC) code.
Visit the Clinical Criteria website to search for specific clinical criteria.
Clinical Criteria |
HCPCS or CPT® code(s) |
Drug |
ING-CC-0164 |
J9281 |
Jelmyto (mitomycin) |
ING-CC-0165 |
J9317 |
Trodelvy (sacituzumab Govitecan-hziy) |
ING-CC-0061 |
J1950 |
Fensolvi (leuprolide acetate) |
Featured In:
April 2021 Anthem Provider News and Important Updates -- Nevada