Elzonris® and Trogarzo™ policies to be archived

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Elzonris^® and Trogarzo^™ policies to be archived

December 6, 2021

AmeriHealth will archive two policies, effective January 3, 2022.

Medical Policy #08.01.55c: Tagraxofusp-erzs (Elzonris^®)

The HCPCS code J9269 Injection, tagraxofusp-erzs, 10 micrograms is eligible for coverage.
A Policy Notification was posted on December 3, 2021.

Medical Policy #08.01.46a: Ibalizumab-uiyk (Trogarzo™)

The HCPCS code J1746 Injection, ibalizumab-uiyk, 10 mg is eligible for coverage.
A Policy Notification was posted on December 3, 2021.

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