Prior Auth Required

02142 - 17 Tysabri prescribing information, Biogen Idec Inc., Cambridge, MA . 10/23 11/24

This procedure appears on the selected insurer prior authorization source.

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Procedure / Service17 Tysabri prescribing information, Biogen Idec Inc., Cambridge, MA . 10/23 11/24
Procedure / Service Description

Label - Label and Off-Label use (L33394) and related local coverage article A52370 bevacizumab and biosimilars 17 Tysabri prescribing information, Biogen Idec Inc., Cambridge, MA 02142. 10/23 11/24 18 Bhadra AK, Altman R, Dasa V, et al. Appropriate Use Criteria for Hyaluronic Acid in the Treatment of Knee 8/16 11/24 Osteoarthritis in the United States. Cartilage. 2017 Jul;8(3):234-254. doi: 10.1177/1947603516662503.

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.