Select medications may require notification and review for medical necessity and coverage decision under the members pharmacy benefit. J7183 Injection von willebrand factor complex human wilate 1iu. Antihemophilic Factor Recombinant Pegylated Rurioctocog Alfa Pegol About ADYNOVATEADYNOVI ADYNOVATEAntihemophilic Factor Recombinant PEGylated was first approved by the Food and Drug Administration FDA in the US. Adynovate j code . It is given by slow injection into a vein. ADYNOVATE provides proven prophylaxis with simple twice-weekly dosing for children and adult patients with hemophilia A helping. NDC Code s. Adynovate C9141 Injection factor viii antihemophilic factor recombinant pegylated-aucl 1 iu. Adynovate can reduce the number of bleeding episodes when used regularly prophylaxis. J7175 Injection factor x human 1 iu. J7207 Injection factor viii antihemophilic factor recombinant pegylated 1 iu. 04012021 This policy addresses the use of Eloctate antihemophilic fac...