J1747, Injection, spesolimab-sbzo, 1 mgHCPCS/CPT
Prior Auth Required
At least one active policy explicitly requires prior authorization (high confidence)
ARKBLUE-SPESOLIMAB-SBZO-E-G-SPEVIGO-A43447ED81, Spesolimab-sbzo (e.g., Spevigo)
AR
BCBSLA-00885-1F6DFC7A65, 00885 spesolimab-sbzo (Spevigo)
LA
BCBSM-2167376-1CE46C9EFE, SPEVIGO (SPESOLIMAB-SBZO)
MI
HEALTHPARTNERS-CC-ENTRY-254279, Spesolimab-sbzo (Spevigo)
MULTI
POINT32HEALTH-MDMNG-13836, Spevigo (spesolimab-sbzo)
MULTI
POINT32HEALTH-MDMNG-23231, Spevigo spesolimab-sbzo)
MULTI
POINT32HEALTH-MDMNG-23241, Spevigo spesolimab-sbzo)
MULTI
POINT32HEALTH-PMNG-23131, Spevigo (spesolimab-sbzo)
MULTI
BCBSNE-X-235-25E281ADC2, SPEVIGO
NE
HEALTHNET_OR-HNOR-SPESOLIMAB-SBZO-SPEVIGO-CP-PHAR-606-97BB762D87, Spesolimab-sbzo (Spevigo); CP.PHAR.606
OR
MODA-SPEVIGO-34C5860590, Spevigo (spesolimab)
OR
MODA-SPEVIGO-SQ-5717973022, Spevigo (spesolimab) SQ
OR
IBX-MEDICARE-ADVANTAGE-MA08-155B-A76A22ED76, Spesolimab-sbzo (Spevigo)
PA
IBX-COMMERCIAL-08-01-97B-856510003E, Spesolimab-sbzo (Spevigo)
PA
OSCAR-SPEVIGO-SPESOLIMAB-SBZO-CG071-VER-5-82B52E028A, Spevigo (spesolimab-sbzo) (CG071, Ver. 5)
UHC-COMM-MD-SPEVIGO-SPESOLIMAB-SBZO-COMMUNITY-PLAN-M-A67D660616, Spevigo (Spesolimab-Sbzo) – Community Plan Medical Benefit Drug Policy
UHC-POL-provider-administered-drugs-soc, Provider Administered Drugs – Site of Care
UHC-EXCH-MD-SPEVIGO-SPESOLIMAB-SBZO-COMMERCIAL-AND-I-DC92109A49, Spevigo (Spesolimab-Sbzo) – Commercial and Individual Exchange Medical Benefit Drug Policy
UHC-POL-spevigo, Spevigo (Spesolimab-Sbzo)
UHC-POL-spevigo-sv, Spevigo (Spesolimab-Sbzo) – IV and Subcutaneous Formulations (for UHCWest Only)
Ask Backwork about documentation requirements, denial risks, or coverage in your state.