Prior Auth Required

90688 - intramuscular use $41.80 vial]) $25.00

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / Serviceintramuscular use $41.80 vial]) $25.00
Procedure / Service Description

Influenza virus vaccine, split virus, preservative free, - Influenza virus vaccine, quadrivalent (IIV4), split virus, 05 Influenza vaccine, inactivated (IIV), subunit, adjuvanted, for mL dosage, for intramuscular use (FluLaval [multidose 90653 intramuscular use $41.80 90688 vial]) $25.00 Influenza virus vaccine, split virus, preservative free, when Diphtheria, tetanus toxoids, and acellular pertussis vaccine administered to individuals 3 years and older, for intramuscular and inactivated poliovirus vaccine (DTaP-IPV), when

Likely documents
  • Confirm benefit details
  • Submit clinical notes if requested by the plan
Next actions
  • Confirm the current plan policy before submission.
  • Use the insurer authorization workflow for this listed code.