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Carbaglu (carglumic acid)United Healthcare

Hyperammonemia due to propionic acidemia (PA)

Initial criteria

  • Diagnosis of hyperammonemia due to one of the following: N-acetylglutamate synthase (NAGS) deficiency OR propionic acidemia (PA) OR methylmalonic acidemia (MMA)

Reauthorization criteria

  • Documentation of positive clinical response to Carbaglu therapy

Approval duration

12 months