MedStar Family Choice-DC follows the American Academy of Pediatrics 2014 guidelines for Synagis (palivizumab) administration (see link below).

Requests for Synagis (palivizumab) require a completed Synagis® Seasonal Respiratory Syncytial Virus Enrollment Form (see link below). Please fax completed forms to Caremark Specialty Pharmacy at 877-552-2907 and a second copy to MedStar Family Choice-DC at 202-243-6258.

If you have questions for MedStar Family Choice-DC, call 855-798-4244.

View the American Academy of Pediatrics 2014 Synagis (palivizumab) Guidelines.

View the AAP recommendations last updated in the Journal of the AAP on August 26, 2022

View the Synagis (palivizumab) Prior Authorization Form.

Information current as of: