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Insurance Verification Request Form - Injectafer

Insurance Verification Request Form - Injectafer 2025

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The document is an Insurance Verification Request Form for the American Regent IV Iron Reimbursement Hotline, designed to facilitate insurance coverage inquiries for Venofer and Injectafer. It requires patient consent to conduct insurance research and includes sections for patient information, diagnosis, insurance details, and prescribing physician information.

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What is the lawsuit against Injectafer?

Following her second injection, Spero suffered severe hypophosphatemia causing extreme pain and potential long-term injuries. This Injectafer lawsuit alleges that Speros injuries were the direct result of the Injectafer and that the defendants negligently failed to warn about this risk.

How much does Injectafer cost without insurance?

The cost for Injectafer intravenous solution ((as elemental iron) 50 mg/mL) is around $207 for a supply of 2 milliliters, depending on the pharmacy you visit.

What is the code for Injectafer?

Injectafer is reimbursable using J code J1439.

What is the patient assistance program for Injectafer?

call 1-866-4-DSI-NOW (1-866-437-4669). Restrictions apply. Ask your doctor to enroll you. They will need the last 4 digits of your Social Security number to confirm youre eligible.

How many infusions are needed for Injectafer?

Each vial of Injectafer is intended for single-use only. Any unused drug remaining after injection must be discarded. For patients weighing 50 kg (110 lb) or more: Give Injectafer in 2 doses separated by at least 7 days.

What is Injectafer used for?

Injectafer is injected into your vein to treat iron deficiency anemia in adults and children 1 year of age and older. Injectafer should be used only if you have not responded well to treatment with oral iron, or if you are intolerant to oral iron treatment.

Insurance Verification Request Form - Injectafer 2025

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