Praluent Prior Authorization Resources

Find the right PA form for your patient's payer, get the ICD-10 codes you need, and download appeal templates — all in one place.

Blue Cross Blue Shield of Arkansas - Pharmacy Prior Authorization Form Arkansas Blue Cross Blue Shield
Blue Cross of Idaho - General Prior Authorization Form Blue Cross of Idaho Health Services, Inc.
California - Uniform Prior Authorization FormCalifornia
CDPHP - General Prior Authorization FormCapital District Physicians Health Plan, Inc.
Cigna - General Medication Prior Authorization FormCigna Corporation
Cigna - Praluent Prior Authorization Form Cigna Corporation

ICD-10 codes for Praluent Prior Authorizations

I21.9Acute myocardial infarction, unspecified
I25.9Chronic ischemic heart disease, unspecified
I63.9Cerebral infarction, unspecified
I20.0Unstable angina
E78.0Pure hypercholesterolemia
E78.01Familial hypercholesterolemia

Support for Getting Your Patient on Praluent

Check coverage & formulary statusVerify PA requirements for your patient's plan.Find savings programsCopay cards, patient assistance, and more.Check medication interactionsScreen prescriptions for harmful drug combinations.