Important information about Synagis^®

Synagis^®, available through McKesson Specialty Pharmacy, treats infants at risk for respiratory syncytial virus (RSV).

Regence has contracted with McKesson Specialty Pharmacy as our preferred Synagis distributor. This contract allows us to provide your eligible patients with Synagis at a reduced rate. Choosing McKesson can save your office time by assisting with:

• Coordination of prior authorization requests for Synagis from Regence
• Delivery of Synagis to your office (packaged appropriately for temperature control)
• Billing of medication directly to Regence (you will need to bill for only the appropriate administration fee)

Synagis requires prior authorization. To request prior authorization:

• Call 1 (800) 572-0316.
• Fax the Pharmacy Prior Authorization Request Form to 1 (800) 884-4282.
• Submit the Pharmacy Prior Authorization Request Form.

After prior authorization is approved, Synagis can be ordered by calling McKesson Specialty at 1 (877) 222-4138.

The following Synagis allowable amounts are set for McKesson Specialty Pharmacy:

PRODUCT	NDC NUMBER	ALLOWED	CPT CODE
Synagis 50 mg/0.5 ml vial (Liquid Formulation)	60574-4114-01	$837.90	90378 (1 unit)
Synagis 100 mg/ 1 ml vial (Liquid Formulation)	60574-4113-01	$1,582.18	90378 (2 units)

 

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