RegAlertReport · DFR · 22 Oct 2026
VT 2025 Top Requested Prior Authorization
This document presents data on the top 10 most requested medical prior authorizations (PAs) and prescription drug PAs for Cigna in Calendar Year 2025, as specified under 2025 VT Act 140. It details medical procedure codes, total requests, and approval percentages, noting MRI Lower Extremity with 144 requests and 91.67% approval. For prescription drug PAs, it lists drug names, total requests, and approval percentages, highlighting MOUNJARO 2.5 MG/0.5 PEN INJCTR with 55 requests and 56.36% approval.
| 2025 VT Act 140 Cigna | ||
|---|---|---|
| Top 10 Most Requested Medical PAs for CY 2025 | ||
| Procedure Code Description | Total Number Requested | Percentage of Approval |
| MRI Lower Extremity, any joint; without contrast material(s) | 144 | 91.67% |
| CT ABDOMEN and PELVIS; with contrast | 108 | 96.30% |
| MRI Lumbar Spine, (spinal canal and contents); without contrast material | 98 | 87.76% |
| Esophagogastroduodenoscopy, Flexible, Transoral; Diagnostic, Including Collection Of Specimen(s) By Brushing Or Washing, When Performed (separate Procedure) | 93 | 90.32% |
| MRI Upper Extremity, any joint; without contrast material(s) | 90 | 83.33% |
| CT CHEST; with contrast | 64 | 96.88% |
| MRI Cervical Spine, (spinal canal and contents); without contrast material | 58 | 81.03% |
| CT CHEST; without contrast | 55 | 100.00% |
| Polysomnography, Sleep Monitoring Of Patient 6 Years Or Older In A Sleep Lab | 49 | 61.22% |
| MRI BRAIN (head); with and without contrast | 49 | 100.00% |
| 2025 VT Act 140 Cigna | ||
|---|---|---|
| Top 10 Most Requested Prescription Drug PAs for CY 2025 | ||
| Drug Name | Total Number Requested | Percentage of Approval |
| MOUNJARO 2.5 MG/0.5 PEN INJCTR | 55 | 56.36% |
| OZEMPIC .25 OR 0.5 PEN INJCTR | 45 | 57.78% |
| OZEMPIC 2MG/0.75ML PEN INJCTR | 24 | 87.50% |
| OZEMPIC 1/0.75 (3) PEN INJCTR | 19 | 68.42% |
| ZEPBOUND 2.5 MG/0.5 PEN INJCTR | 17 | 64.71% |
| NURTEC ODT 75 MG TAB RAPDIS | 15 | 73.33% |
| HUMIRA(CF) PEN 40MG/0.4ML PEN IJ KIT | 11 | 45.45% |
| ALBUTEROL SULFATE HFA 90 MCG HFA AER AD | 11 | 27.27% |
| MOUNJARO 7.5 MG/0.5 PEN INJCTR | 11 | 81.82% |
| STELARA 90 MG/ML SYRINGE | 10 | 80.00% |
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