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CONTAINS CONFIDENTIAL PATIENT INFORMATION Provence (sipuleucalT) Prior Authorization of Benefits (PAB) Form Complete form in its entirety and fax to: Prior Authorization of Benefits Center at 18006014829

How to fill out provenge sipuleucal-t

How to fill out provenge sipuleucal-t?

1. Ensure that you have received the necessary training and information from your healthcare provider about how to properly administer provenge sipuleucal-t.
2. Gather all the required materials, including the provenge sipuleucal-t kit, a sterile syringe, and alcohol wipes.
3. Wash your hands thoroughly with soap and water before starting the process.
4. Check the expiration date on the provenge sipuleucal-t kit to ensure it is still valid.
5. Open the kit and remove the vial containing the sipuleucal-t product.
6. Clean the top of the vial using an alcohol wipe to maintain sterility.
7. Use a syringe to withdraw the entire contents of the sipuleucal-t vial.
8. Choose an appropriate injection site, typically in the upper thigh or abdomen, as directed by your healthcare provider.
9. Clean the injection site with an alcohol wipe.
10. Slowly inject the entire contents of the syringe into the chosen injection site.
11. After injecting, remove the needle from the injection site and dispose of it properly.
12. Gently apply pressure to the injection site with a clean, sterile cotton swab to minimize bleeding.
13. Dispose of all used materials as directed by your healthcare provider.

Who needs provenge sipuleucal-t?

1. Provenge sipuleucal-t is a treatment specifically designed for patients with advanced prostate cancer that has not responded to other treatments.
2. It is indicated for patients who have metastatic castration-resistant prostate cancer, meaning their cancer has spread outside the prostate gland.
3. Provenge sipuleucal-t is typically used when the cancer has progressed despite hormone therapy and has shown resistance to other treatments like chemotherapy.

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What is provenge sipuleucal-t?

Provenge (sipuleucel-T) is a treatment for advanced prostate cancer.

Who is required to file provenge sipuleucal-t?

Healthcare providers who administer Provenge (sipuleucel-T) are required to file.

How to fill out provenge sipuleucal-t?

Provenge (sipuleucel-T) is typically administered through a healthcare facility. The provider will be responsible for filling out the necessary paperwork.

What is the purpose of provenge sipuleucal-t?

The purpose of Provenge (sipuleucel-T) is to stimulate the body's immune system to target and attack prostate cancer cells.

What information must be reported on provenge sipuleucal-t?

The information reported on Provenge (sipuleucel-T) filings typically includes details on the patient receiving the treatment, the healthcare provider administering the treatment, and the dosage given.