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HCPCS/CPT J8611, Methotrexate (jylamvo), oral, 2.5 mg | Prior Auth Required

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`J8611`, Methotrexate (jylamvo), oral, 2.5 mg

HCPCS/CPT

Prior Authorization

Prior Auth Required

Conditional coverage; review criteria to confirm PA need (medium confidence)

Medicare Pricing

Work RVU

0.00

Facility

N/A

Non-Facility

N/A

2 Active Policies

BCBSLA-00602-B679814CAD, 00602 methotrexate oral solution (Xatmep, Jylamvo)

LA

HEALTHNET_OR-HNOR-METHOTREXATE-OTREXUP-RASUVO-REDITREX-XATMEP-JYLAMVO-CP-P-16F0E61072

, Methotrexate (Otrexup, Rasuvo, Reditrex, Xatmep, Jylamvo); CP.PHAR.134

OR

Related Codes

J8610(2 policies)J8612(2 policies)

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