Prior Auth Required

90649 - (GARDASIL) $146.95 schedule, live, for oral use (Rotarix) $92.00

This procedure appears on the selected insurer prior authorization source.

Check another codeExplore policy data
Prior authorizationPrior Auth Required
Procedure / Service(GARDASIL) $146.95 schedule, live, for oral use (Rotarix) $92.00
Procedure / Service Description

Influenza virus vaccine, split virus, preservative free, - Human Papilloma virus (HPV) vaccine, types 6, 11, 16, 18 (4vHPV quadrivalent), 3 dose schedule, for intramuscular use Rotavirus vaccine, human, attenuated (RV1), 2 dose 90649 (GARDASIL) $146.95 90681 schedule, live, for oral use (Rotarix) $92.00 Human Papilloma virus (HPV) vaccine, types 6, 11, 16, 18, 31, Influenza virus vaccine, quadrivalent (IIV4), split virus, 33, 45, 52, 58 (9vHPV quadrivalent), 2 or 3 dose schedule, for preservative free, 05 mL dosage, for intramuscular use

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.