No prior authorization required for:

• Emergency room
• Inpatient
• Skilled nursing facility
  
  

For further information, please see the Injectable Drugs page

Code(s): J9310

Benefit: Medical

Notes:

• 10mg/mL
• When authorized, Rituxan® will be approved at a dose of 375mg/m2 for all indications except RA.
• Approved dosing for RA is 1,000mg every two weeks.

Length of initial authorization: 3 months.

Length of continuation authorization: 12 months.