Axicabtagene ciloleucel, up to 200 million autologous anti-cd19 car positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose
Short Description: Axicabtagene ciloleucel car+
Coverage Code: Carrier judgment
Action Code: No maintenance for this code
Date Added: April 1, 2018
Effective Date: January 1, 2019
Termination Date: