Anthem: Eylea HD Payer Policy (Beta Access)
- HCPCS code(s): J0177
- Link to Policy - (Click here for full policy)
- Step therapy required: Not Provided
- Site of Care Requirement: No
- Provider fax form: ❌ Not Yet Available in SamaCare
- To request the addition of this form to our database, please email us at Help@samacare.com, including a blank PDF version of the authorization form.
- FDA-Approved Indications: Not Provided
- Recommended Dose: Not Provided
- Other Pertinent Information:
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