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PHONE: 855.859.1738 FAX: 844.443.7933 Pharmacy Services Department Pharmacy Services INTRAVENOUS & SUBCUTANEOUS IMMUNE GLOBULIN (IVG & SCI)Department Prior Authorization Form Standard Request (72
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What is immune globulins - prior?
Immune globulins - prior are antibodies that provide passive immunity against specific antigens.
Who is required to file immune globulins - prior?
Healthcare professionals or institutions administering immune globulins - prior are required to file.
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Immune globulins - prior can be filled out by providing information on the patient, the specific antibodies administered, and the administering healthcare professional.
What is the purpose of immune globulins - prior?
The purpose of immune globulins - prior is to boost the immune system and provide protection against certain infections.
What information must be reported on immune globulins - prior?
Information such as patient demographics, dosage administered, administration route, and any adverse reactions must be reported on immune globulins - prior.
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