Crysvita (Burosumab-twza) (Ultragenyx)
- X-Linked Hypophosphatemia
- Need serum phosphorus & patient weight
Instructions
- Please open authorization forms at left. Fill out the forms on your computer, save and print.
- Open Physician Orders for the office of your choice (at left). Save to your computer, print and fill out.
- The following tests should be performed and test results faxed to Pacific Infusion before the patient’s first visit: Crysvita – Serum Phosphorus
- Fax the following to Pacific Infusion Center (310) 297-9222:
- Completed and signed forms/order
- Copy of the patient’s insurance card(s)
- Demographics
- OV notes
- Tried and failed medications
- Labs
- Drug Enrollment Forms
- After the patient’s infusion appointment, one of our nurses will fax a copy of the infusion notes to your office.