Prior Auth Required

90732 - use (Pneumovax23) $95.00 REQUIRED $15.00

This procedure appears on the selected insurer prior authorization source.

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Procedure / Serviceuse (Pneumovax23) $95.00 REQUIRED $15.00
Procedure / Service Description

Tetanus, diphtheria toxoids and acellular pertussis vaccine - or immunosuppressed patient dosage, when administerd to individuals 2 years or older, for subcutaneous or intramuscular Injection, ceftriaxone sodium, per 250 mg-AUTH 90732 use (Pneumovax23) $95.00 J0696 REQUIRED $15.00 Meningococcal polysaccharide vaccine serogroups A, C, Y, W- 135, quadrivalent (MPSV4), for subcutaneous use (Menomune- Injection, ceftriaxone sodium, per 500 mg-AUTH

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.