Does 15983pa0030003 cover hyaluronidase / immunoglobulin G?
15983pa0030003
15983-15983PA0030003-0 · ACA · ACA Marketplace
hyaluronidase / immunoglobulin G
hyaluronidase / immunoglobulin Gunder 15983pa0030003
Covered — requires prior authorization
Your plan has to approve it first — your doctor’s office handles it.
What you'd pay
This plan doesn't publish a price for this tier. Your pharmacy can quote it before you fill.
- Tier
- Specialty drugs
- Approval first
- Required
- Try another first
- No
- Amount limit
- None
Talk to your pharmacist or doctor before acting on anything here. They can see your full history and this page cannot. Never start, stop, or switch a medication based on it. Coverage rules change and plans make exceptions — your pharmacy can check your exact benefit in seconds.As of Sep 14, 2026 · CMS QHP machine-readable. Reference information, not medical advice and not a price.
Covered forms and strengths (5)
- {1 (1.25 ML hyaluronidase, human recombinant 160 UNT/ML Injection) / 1 (25 ML immunoglobulin G, human 100 MG/ML Injection) } Pack [Hyqvia 2.5 G / 25 ML Kit]Approval first
- {1 (10 ML hyaluronidase, human recombinant 160 UNT/ML Injection) / 1 (200 ML immunoglobulin G, human 100 MG/ML Injection) } Pack [Hyqvia 20 G / 200 ML Kit]Approval first
- {1 (100 ML immunoglobulin G, human 100 MG/ML Injection) / 1 (5 ML hyaluronidase, human recombinant 160 UNT/ML Injection) } Pack [Hyqvia 10 G / 100 ML Kit]Approval first
- {1 (15 ML hyaluronidase, human recombinant 160 UNT/ML Injection) / 1 (300 ML immunoglobulin G, human 100 MG/ML Injection) } Pack [Hyqvia 30 G / 300 ML Kit]Approval first
- {1 (2.5 ML hyaluronidase, human recombinant 160 UNT/ML Injection) / 1 (50 ML immunoglobulin G, human 100 MG/ML Injection) } Pack [Hyqvia 5 G / 50 ML Kit]Approval first