Krystexxa (pegloticase) [Horizon]
- Refractory chronic gout
- Need serum uric acid 24-48 hours prior to each infusion and glucose 6-PD before initiation of therapy
- 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:
Krystexxa – Uric acid, glucose 6-PD
- Fax the completed, signed forms and a copy of the patient’s insurance card to: Pacific Infusion Center (310) 297-9222.
- After the patient’s infusion appointment, one of our nurses will fax a copy of the infusion notes to your office.