Received Apr 22, 2026
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| VARCEL | VARICELLA (NO BRAND NAME) | UNKNOWN MANUFACTURER | UNK | — | — |
determ letter states: "The use of this medication without the prescriber assessing the patient for medical appropriateness for varicella vaccination prior to therapy does not establish medical necessity for this drug. Medical necessity is determined by the adherence to generally accepted standards of medical practices in (withheld), is clinically appropriates, in terms of type, frequency, extent, site, duration, and considered effective for the patient's illness, injury, disease, or its symptoms." No consent to follow up. INC-104282