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HCPCS/CPT J2406, Injection, oritavancin (kimyrsa), 10 mg | Prior Auth Required

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`J2406`, Injection, oritavancin (kimyrsa), 10 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

2 Active Policies

BCBSMS-L-5-01-631-7C8BABC40E, Kimyrsa (oritavancin)

MS

BCBSMS-S-5-01-631-9B16FB1029

, State and School Employees' Health Insurance Plan - Kimyrsa (oritavancin)

MS

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