Medical Criteria Update April 6, 2022

Medical Criteria	Reason for Update
Place of Service	Added the following drugs and HCPCS codes for clarity, with criteria also available in individual policies: Nexviazyme (C9085, J3490, J3590), Saphnelo (C9086, J3490, J3590), Tezspire (C9399, J3490, J3590), Enjaymo (C9399 J3490, J3590**), and Leqvio (C9399, J3490, J3590). Updated HCPCS code for Evkeeza to J1305.

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