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Highmark Provider Manual
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Requiring Authorization
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Medical Injectable Drug Forms
Outpatient Chemotherapy Aloxi (J1469)
Outpatient Chemotherapy
Outpatient Chemotherapy Granulocyte Colony-Stimulating Factors
Outpatient Medical Injectable Botox - Hyperhydrosis
Outpatient Medical Injectables Botulinum Toxin-Chemodenervation
Outpatient Medical Injectable Intra-Articular Hyaluronan Injections
Outpatient Medical Injectable Intravitreal Injection
Outpatient Medical Injectable Monoclonal Antibodies For The Treatment Of Eosinophilic Conditions
Outpatient Medical Injectable Prolia Authorization
Last updated on 9/21/2021
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