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.

Last verified: May 11, 2026

Blue Cross Blue Shield of Arkansas - Pharmacy Prior Authorization Form Arkansas Blue Cross Blue Shield · Updated May 11, 2026
Blue Cross Blue Shield of Massachusetts - Med UM Policy - Pharmacy Prior AuthorizationBlue Cross Blue Shield of Massachusetts · Updated May 10, 2026
Blue Cross Blue Shield of North Dakota - Medicaid Expansion Restricted Use Precertification Drug ListBlue Cross Blue Shield of North Dakota · Updated May 10, 2026
Blue Cross of Idaho - General Prior Authorization Form Blue Cross of Idaho Health Services, Inc. · Updated May 11, 2026
California - Uniform Prior Authorization FormCalifornia · Updated Apr 16, 2026
CDPHP - General Prior Authorization FormCapital District Physicians Health Plan, Inc. · Updated May 11, 2026

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

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