Virginia
Provider Communications
Anthem removes drugs from specialty pharmacy clinical site of care (level of care) drug list
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 pre-service clinical review for medical necessity.
Coverage or Clinical Guideline |
Drug |
Code |
CG-DRUG-100 |
Actimmune® |
J9216 |
DRUG.00086 |
Increlex® |
J2170 |
CG-DRUG-60 |
Firmagon® |
J9155 |
Featured In:
August 2018 Anthem Provider Newsletter -- Virginia