Prior Auth Required

90743 - subcutaneous use (M-M-R II) $75.00 intramuscular use (Energix-B, Recombivax HB) $35.00

This procedure appears on the selected insurer prior authorization source.

Check another codeExplore policy data
Prior authorizationPrior Auth Required
Procedure / Servicesubcutaneous use (M-M-R II) $75.00 intramuscular use (Energix-B, Recombivax HB) $35.00
Procedure / Service Description

Diphtheria, tetanus toxoids, and acellular pertussis vaccine - 90702 USP [For Pediatric Use]) $20.00 90740 (Recombivax dialysis) $70.00 Measles, mumps and rubella virus vaccine (MMR), live, for Hepatitis B vaccine (HepB), adolescent 2 dose schedule, for 90707 subcutaneous use (M-M-R II) $75.00 90743 intramuscular use (Energix-B, Recombivax HB) $35.00 Hepatitis B vaccine (HepB), pediatric/adolescent dosage 3 Measles, mumps, rubella, and varicella vaccine (MMRV), live, for dose schedule, for intramuscular use (Energix-B,

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.