Aphexda Prior Authorization Resources

Find the right PA form for your patient's payer, get the ICD-10 codes you need, and download appeal templates — all in one place.

Blue Cross Blue Shield of Arkansas - Pharmacy Prior Authorization Form Arkansas Blue Cross Blue Shield
Blue Cross Blue Shield of Massachusetts - Med UM Policy - Pharmacy Prior AuthorizationBlue Cross Blue Shield of Massachusetts
Blue Cross Blue Shield of North Dakota - Medicaid Expansion Restricted Use Precertification Drug ListBlue Cross Blue Shield of North Dakota
Blue Cross of Idaho - General Prior Authorization Form Blue Cross of Idaho Health Services, Inc.
California - Uniform Prior Authorization FormCalifornia
CDPHP - General Prior Authorization FormCapital District Physicians Health Plan, Inc.

ICD-10 codes for Aphexda Prior Authorizations

C90.00Multiple myeloma not having achieved remission
C90.01Multiple myeloma in remission
C90.02Multiple myeloma in relapse

Brand Resources

BioLineRx Connect Enrollment Form BioLineRx Connect Enrollment Form resource

Support for Getting Your Patient on Aphexda

Check coverage & formulary statusVerify PA requirements for your patient's plan.Find savings programsCopay cards, patient assistance, and more.Check medication interactionsScreen prescriptions for harmful drug combinations.