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Section 503A pharmacies (traditional compounding pharmacies) can still compound tirzepatide under limited circumstances when a prescriber documents that a patient requires a clinically significant modification, such as an alternative formulation due to allergy or intolerance to an inactive ingredient in the commercial product

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Payers reviewing D62 claims expect estimated blood loss documented in the operative or emergency note, vital sign changes indicating hypovolemia such as tachycardia and hypotension, and a treatment plan involving transfusion or fluid resuscitation