2 5. Does not have active infection(s) or inflammatory disorders 6. Have not received prior FDA approved, BCMA-directed, chimeric antigen receptor T therapy.

2 7. Are adults (age ≥18) at the time of infusion 8. Have a documented diagnosis of multiple myeloma 9. Have relapsed* or refractory disease* after 4 or more prior lines of therapy*, including an

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4 78815 PET imaging, with concurrently acquired CT for attenuation correction and anatomic localization; skull base to mid-thigh 78816 PET imaging, with concurrently acquired CT for attenuation correction and anatomic

3 Massachusetts Collaborative — Massachusetts Standard Form for Prescription Drug Prior Authorization Requests April 2024 (version 1.0)

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