J1640, Injection, hemin, 1 mg
HCPCS/CPT
Prior Authorization
Prior Auth Required
Conditional coverage; review criteria to confirm PA need (medium confidence)
Medicare Pricing
Work RVU
0.00
Facility
N/A
Non-Facility
N/A
5 Active Policies
HEALTHNET_OR-HNOR-HEMIN-PANHEMATIN-CP-PHAR-181-D3AD187F14, Hemin (Panhematin); CP.PHAR.181
OR
IBX-COMMERCIAL-08-00-21A-92E927E276, Givosiran (Givlaari) and Panhematin (Hemin)
PA
IBX-MEDICARE-ADVANTAGE-MA08-112A-7946670779, Givosiran (Givlaari) and Panhematin (Hemin)
PA
AMERIHEALTH-COMMERCIAL-08-00-21A-3DD730F942, Givosiran (Givlaari) and Panhematin (Hemin)
Related Codes
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