Plans of Treatment
Palmetto Infusion Plans of Treatment
To refer a patient, please choose the appropriate plan of treatment from the list below and fax to 1‐866‐872‐8920, or call 1‐800‐809‐1265 for assistance. Providers can also submit a plan of treatment electronically using the “Upload POTs/Referral Docs” button below.
- Actemra Pediatric Rheumatology Plan of Treatment
- Actemra Plan of Treatment Adult Giant Cell Arteritis
- Actemra Plan of Treatment Adult Rheumatology
- Adakveo Plan of Treatment
- Albumin Standard Plan of Treatment
- Alpha 1-Antitrypsin Deficiency Standard Plan of Treatment
- Amvuttra Plan of Treatment
- Antibiotics (Anti-infective) Standard Plan of Treatment
- Antiemetic Standard Plan of Treatment
- Aredia (pamidronate disodium) Standard Plan of Treatment
- Avsola Dermatology Plan of Treatment
- Avsola Gastroenterology Plan of Treatment
- Avsola Rheumatology Plan of Treatment
- Avsola Standard Plan of Treatment
- Benlysta Standard Plan of Treatment
- Boniva (ibandronate sodium) Standard Plan of Treatment
- Cabenuva Standard Plan of Treatment
- Cerezyme POT ICD 10 102215
- Cimzia Plan of Treatment for Gastroenterology
- Cimzia Plan of Treatment for Rheumatology
- Cinqair Plan of Treatment
- Crysvita Plan of Treatment for Adult Patients
- Crysvita Plan of Treatment for Pediatric Patients
- Cytoxan (Cyclophosphamide) Plan of Treatment (Not available in all locations)
- Dalvance Plan of Treatment
- Detail Written Order
- Elaprase POT ICD 10 102215
- Entyvio Gastroenterology Plan of Treatment
- Evenity Standard Plan of Treatment
- Evkeeza Standard Plan of Treatment
- Fabrazyme Standard Plan of Treatment
- Fasenra Standard Plan of Treatment
- Generic or Blank Plan of Treatment
- Givlaari Plan of Treatment
- Hydration Standard Plan of Treatment
- HyQvia Standard Plan of Treatment
- Ilumya Plan of Treatment
- Immunoglobulin Subcutaneous Standard Plan of Treatment
- Immunogobulin (IVIG) Plan of Treatment
- Inflectra Dermatology Plan of Treatment
- Inflectra Gastroenterology Plan of Treatment
- Inflectra Rheumatology Plan of Treatment
- Inflectra Standard Plan of Treatment
- Intralipids
- Iron Standard Plan of Treatment
- Kimyrsa Standard Plan of Treatment
- Krystexxa Standard Plan of Treatment
- Krystexxa Monitoring Protocol and Pre-infusion Medications
- Lemtrada Plan of Treatment (Not available in all locations)
- Leqvio Plan of Treatment
- Levothyroxine Standard Plan of Treatment
- Line Care Alteplase (Cathflo Activase) Standard Plan of Treatment
- Line Care for Dialysis or Hemapheresis Catheter Plan of Treatment
- Line Care Standard Plan of Treatment
- Lumizyme POT ICD 10 102215
- Magnesium Standard Plan of Treatment
- Nexviazyme Standard Plan of Treatment
- Nucala Plan of Treatment for Asthma
- Nucala Plan of Treatment for EGPA
- Nucala Standard Plan of Treatment
- Nucala Standard Plan of Treatment for Nasal Polyps
- Nulojix Standard Plan of Treatment
- Ocrevus Plan of Treatment
- Onpattro Plan of Treatment
- Orbactiv Standard Plan of Treatment
- Orencia Adult Rheumatology Plan of Treatment
- Orencia Pediatric Rheumatology Plan of Treatment
- Physician Verbal Order DWO
- Prolia Standard Plan of Treatment
- Radicava Plan of Treatment
- Reclast (zoledronic acid) Standard Plan of Treatment
- Remicade Dermatology Plan of Treatment
- Remicade Gastroenterology Plan of Treatment
- Remicade Rheumatology Plan of Treatment
- Remicade Standard Plan of Treatment
- Renflexis Plan of Treatment for Dermatology
- Renflexis Plan of Treatment Gastroenterology
- Renflexis Plan of Treatment for Rheumatology
- Renflexis Standard Plan of Treatment
- Riabni Plan of Treatment for GPA or MPA
- Riabni Plan of Treatment for Rheumatology
- Rituxan Plan of Treatment for GPA or MPA
- Rituxan Plan of Treatment for Rheumatology
- Ruxience Standard Plan of Treatment for GPA or MPA
- Ruxience Plan of Treatment for Rheumatology
- Saphnelo Standard Plan of Treatment
- Simponi ARIA Standard Plan of Treatment
- Skyrizi Plan of Treatment for Gastroenterology
- Soliris Plan of Treatment for aHUS
- Soliris Plan of Treatment for aHUS for Pediatric Patients
- Soliris Plan of Treatment for Myasthenia Gravis
- Soliris Plan of Treamtent for NMOSD
- Soliris Plan of Treatment for PNH
- Solumedrol (Methylprednisolone) Plan of Treatment
- Standing Adverse Reaction Orders
- Stelara Plan of Treatment for Rheumatology
- Stelara Plan of Treatment for Gastroenterology
- Tepezza Plan of Treatment
- Tezspire Plan of Treatment
- TPN Plan of Treatment
- Trogarzo Plan of Treatment
- Truxima Plan of Treatment for GPA or MPA
- Truxima Plan of Treatment for Rheumatology
- Tysabri Plan of Treatment for Crohn’s Disease
- Tysabri Standard Plan of Treatment
- Tysabri Plan of Treatment for Multiple Sclerosis
- Ultomiris Plan of Treatment
- Uplizna Plan of Treatment
- Vimizim Plan of Treatment
- Vpriv Plan of Treatment
- Vyepti Plan of Treatment
- Vyvgart Plan of Treatment
- Xolair Standard Plan of Treatment for Asthma
- Xolair Standard Plan of Treatment for Nasal Polyps
- Xolair Standard Plan of Treatment for Urticaria
- Xgeva Plan of Treatment
- Zemdri Plan of Treatment