RA Messages for November 28, 2000
PHARMACY PROVIDERS, PLEASE NOTE!!!
IF YOU ARE UNSURE ABOUT THE COVERAGE OF A DRUG PRODUCT,
PLEASE CONTACT
THE PBM HELP DESK AT 1-800-648-0790
NEW VERSIONS OF APPENDICES A, B & C
ARE IN THE MAIL. THEY ARE DATED
12/09/00 AND INCLUDE NEW FUL DATA EFFECTIVE 12/7/00.
PLEASE MAKE THE FOLLOWING CHANGES TO THE
12/9/00 VERSION OF
APPENDIX A:
| DRUG |
DOSAGE |
STRGTH |
MAC |
EFF.DATE |
| AMITRIPTYLINE HCL |
TAB |
25MG |
0.03300 |
12/07/00 |
| CLOBETASOL PROPIONATE |
FOAM |
0.05% |
|
10/13/00 |
| HALOPERIDOL |
TAB |
0.5MG |
0.03600 |
12/07/00
|
| HALOPERIDOL |
TAB |
5MG |
0.51000 |
12/07/00 |
PLEASE FILE ADJUSTMENTS FOR CLAIMS WHICH MAY HAVE BEEN
INCORRECTLY PAID.
PROVIDERS WHO SUBMIT PROBLEM CLAIMS FOR RESEARCH AND A WRITTEN RESPONSE TO
THE DHH TPL UNIT MUST SUBMIT A COVER LETTER EXPLAINING THE PROBLEM OR QUESTION,
A COPY OF THE CLAIM(S), AND ALL PERTINENT DOCUMENTATION. CLAIMS RECEIVED WITHOUT
A COVER LETTER WILL BE SENT DIRECTLY TO CLAIMS PROCESSING WITHOUT A REVIEW OF
ANY KIND.