J1744 prior authorization | Aetna

J1744, Hereditary angioedema agents: Firazyr SC (icatibant acetate) — precertification required for Commercial, is on the Aetna prior authorization list. Not a coverage or referral decision.

Code: J1744
Description: Hereditary angioedema agents: Firazyr SC (icatibant acetate) — precertification required for Commercial
Description: Hereditary angioedema agents: Sajazir SC (icatibant acetate) — precertification required for Commercial
Source: Participating provider precertification list for Aetna, Pg 24 Original policy
Source: Participating provider precertification list for Aetna, Pg 24 Original policy

Aetna prior authorization

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