Prior Auth Required

90284 - CUVITRU IMMUNE GLOBULIN x SAD** 10/06/2016 n/a

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceCUVITRU IMMUNE GLOBULIN x SAD** 10/06/2016 n/a
Procedure / Service Description

HCPCS/ DRUG NAME GENERIC/ ALTERNATE DRUG NAME PADP CE/ SAD**/ DRUG CODE COMMENTS - 90283 OCTAGAM IMMUNE GLOBULIN 05/24/2004 n/a 90283 PRIVIGEN IMMUNE GLOBULIN 01/01/2008 n/a 90284 CUVITRU IMMUNE GLOBULIN x SAD** 10/06/2016 n/a 90284 GAMMAGARD LIQUID IMMUNE GLOBULIN x BOTH*** 07/01/2005 n/a 90284 GAMMAKED IMMUNE GLOBULIN x BOTH*** 08/03/2011 n/a

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.