Prior Auth Required

90634 - schedule, for intramuscular use (Harvix) $30.00 intramuscular use (Prevnar13) $195.00

This procedure appears on the selected insurer prior authorization source.

Prior authorizationPrior Auth Required
Procedure / Serviceschedule, for intramuscular use (Harvix) $30.00 intramuscular use (Prevnar13) $195.00
Procedure / Service Description

Influenza virus vaccine, split virus, preservative free, - 90633 schedule, for intramuscular use (Harvix, Vaqta) $32.03 90662 for intramuscular use (FLUZONE high-dose) $45.00 Hepatitis A vaccine, pediatric/adolescent dosage-3 dose Pneumococcal conjagate vaccine, 13 valent (PCV13). For 90634 schedule, for intramuscular use (Harvix) $30.00 90670 intramuscular use (Prevnar13) $195.00 Influenza virus vaccine, quadrivalent (ccIIV4), derived from Hemophilus influenza b vaccine (Hib), PRP-OMP conjugate (3 cell cultures, subunit preservative and antibiotic free, 0.5

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.