CommercialAugust 1, 2018
Empire removes drugs from specialty pharmacy clinical site of care
Beginning January 1, 2024, Empire became Anthem. This article, published under the former brand, now applies to Anthem.
Effective immediately, the following specialty pharmacy codes from new or current coverage guidelines will be removed from our existing specialty pharmacy clinical site of care review process.
Please note, these drugs will continue to require prior authorization clinical review for medical necessity.
Medical Policy or Clinical Guideline |
Drug |
Code |
CG-DRUG-100 |
Actimmune® |
J9216 |
DRUG.00086 |
Increlex® |
J2170 |
CG-DRUG-60 |
Firmagon® |
J9155 |
PUBLICATIONS: August 2018 Empire Provider Newsletter
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