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Zolgensma (onasemnogene abeparvovecxioi) for Spinal Muscular Atrophy (SMA) Prior Authorization Request Form #085 Medical Policy #008 Zolgensma (onasemnogene abeparvovecxioi) for Spinal Muscular Atrophy

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How to fill out 085 zolgensma onasemnogene abeparvovec-xioi

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Who needs 085 zolgensma onasemnogene abeparvovec-xioi?

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Individuals diagnosed with spinal muscular atrophy (SMA) may need 085 zolgensma onasemnogene abeparvovec-xioi as it is a gene therapy used to treat this genetic disorder.

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Consult with a healthcare provider to determine if this treatment is suitable for the specific case and condition.

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What is 085 zolgensma onasemnogene abeparvovec-xioi?

085 Zolgensma onasemnogene abeparvovec-xioi is a gene therapy used to treat spinal muscular atrophy (SMA) in pediatric patients.

Who is required to file 085 zolgensma onasemnogene abeparvovec-xioi?

Healthcare providers who administer or prescribe 085 Zolgensma onasemnogene abeparvovec-xioi are required to file the necessary documentation.

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To fill out 085 Zolgensma onasemnogene abeparvovec-xioi, healthcare providers need to include patient information, treatment details, and any adverse reactions.

What is the purpose of 085 zolgensma onasemnogene abeparvovec-xioi?

The purpose of 085 Zolgensma onasemnogene abeparvovec-xioi is to provide a gene therapy treatment for spinal muscular atrophy (SMA) in pediatric patients.

What information must be reported on 085 zolgensma onasemnogene abeparvovec-xioi?

Information such as patient demographics, dosing details, and any adverse events must be reported on 085 Zolgensma onasemnogene abeparvovec-xioi.

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