HumanaCommercial Clinical Policy

Auryxia (ferric citrate) Form

Chat with GenHealth to automate any policy or prior auth task.


Auryxia (ferric citrate) for hyperphosphatemia in CKD on dialysis

Notes: Initial Auryxia (ferric citrate) will be approved for a plan year duration or as determined through clinical review.

Indications

(205103) Does the patient have a diagnosis of hyperphosphatemia? 
(205104) Does the patient have chronic kidney disease (CKD)? 
(205105) Is the patient on dialysis? 
(205106) Has the patient had previous treatment, contraindication, or intolerance with calcium acetate (tablet OR capsule) AND sevelamer carbonate? 

Auryxia (ferric citrate) for iron deficiency anemia in CKD

Notes: Initial Auryxia (ferric citrate) will be approved for a plan year duration or as determined through clinical review.

Indications

(205107) Does the patient have a diagnosis of iron deficiency anemia? 

YesNoN/A
YesNoN/A

Sign up to see the rest of the questions

Unlock the remaining questions and the full coverage workflow.

Sign up for free
Effective Date

01/01/2021

Last Reviewed

03/22/2023

Original Document

  Reference



.

Book a walkthrough

Walk through this policy with us

Review how this policy can be converted into cited criteria, prior authorization checks, and operational automation.