Prior Auth Required

90736 - for intramuscular use (Daptacel, Infanrix) $30.00 injection $200.00

This procedure appears on the selected insurer prior authorization source.

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Procedure / Servicefor intramuscular use (Daptacel, Infanrix) $30.00 injection $200.00
Procedure / Service Description

Diphtheria, tetanus toxoids, and acellular pertussis vaccine - Diphtheria, tetanus toxoids, and acellular pertussis vaccine (DTaP), when administered to individuals younger than 7 years, Zoster (shingles) vaccine (HZV), live, for subcutaneous 90700 for intramuscular use (Daptacel, Infanrix) $30.00 90736 injection $200.00 Diphtheria and tetanus toxoids (DT) adsorbed when administered to individuals younger than 7 years, for Hepatitis B vaccine (HepB), dialysis or immunosuppressed

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.