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Synagis (palivizumab) | EviCore by Evernorth | Backwork

Payers/EviCore by Evernorth/EVICORE-MEDICAL_DRUG-0F9861732C0B

Synagis (palivizumab)

EviCore by Evernorth · PayerPolicy · EVICORE-MEDICAL_DRUG-0F9861732C0B

Status: Active
Effective: October 1, 2025
Last reviewed by EviCore by Evernorth: July 29, 2025
Last checked by Backwork: September 30, 2026

Summary of the payer’s published policy. Not a coverage determination — confirm with EviCore by Evernorth before submitting.

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