90624 MENINGOCOCCAL PENTAVALENT VACCINE, MEN B-4C RECOMBINANT PROTEINS AND OUTER MEMBRANE VESICLE AND CONJUGATED MEN A, C, W, Y-DIPHTHERIA TOXOID CARRIER, FOR INTRAMUSCULAR USE

Blue Cross Blue Shield of Michigan and Blue Care Network · PayerPolicy · BCBSM-2199274

Status: Active
Last checked by Backwork: September 30, 2026

Summary of the payer’s published policy. Not a coverage determination — confirm with Blue Cross Blue Shield of Michigan and Blue Care Network before submitting.

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