Aflibercept Products (Eylea; EyleaHD, Ahzantive [aflibercept-mrbb], Enzeevu [Aflibercept-abzv], Eydenzelt [Aflibercept-boav], Opuviz [Aflibercept-yszy], Pavblu [Aflibercept-ayyh], and Yesafili [Aflibercept-jbvf])

BlueCross BlueShield of Tennessee · PayerPolicy · BCBSTN-ce0678f4d9

Summary of the payer’s published policy. Not a coverage determination — confirm with BlueCross BlueShield of Tennessee before submitting.

Free account. Policy pages stay open to everyone.

Codes in this policy

Each code’s status is what the policy records for it. This page does not show the policy’s criteria. Read them in the payer’s source.

Codes labeled “Inferred from policy title” are not listed in the policy document; Backwork attached them because the policy title names the drug.

Codes this policy lists and each code’s status in the policy
Code	Code system	Status in this policy
Q5147	HCPCS	Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug.