J0122, Injection, eravacycline, 1 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
1 Active Policy
BCBSM-2102114-16CA579DB9, ERAVACYCLINE: XERAVA (no code) RETIRED AS OF 10/8/2020
MI
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