RA Messages for November 30, 2004
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
PLEASE MAKE THE FOLLOWING CHANGES TO THE APPENDIX A:
DRUG |
DOSAGE |
STRGTH |
MAC |
EFF DATE |
AMOXICILLIN |
TAB CHEW |
250MG |
OFF MAC |
11/12/04 |
BACLOFEN |
TABLET |
10MG |
$0.44920 |
11/12/04 |
BACLOFEN |
TABLET |
20MG |
$0.84380 |
11/12/04 |
DOXYCYCLINE HYCLATE |
CAPSULE |
100MG |
$0.14910 |
11/12/04 |
ERYTHROMYCIN |
CAPSULE |
250MG |
$0.26209 |
11/12/04 |
FLUOXETINE HCL |
CAPSULE |
20MG |
$0.25200 |
11/12/04 |
GRISEOFULVIN ULTRAMICROSIZE |
TABLET |
125MG |
OFF MAC |
10/01/04 |
HYDROCHLOROTHIAZIDE |
TABLET |
25MG |
$0.05770 |
11/12/04 |
HYDROCHLOROTHIAZIDE |
TABLET |
50MG |
$0.10190 |
11/12/04 |
ISOSORBIDE DINITRATE |
TABLET |
5MG |
$0.02170 |
11/12/04 |
ISOSORBIDE DINITRATE |
TABLET |
10MG |
$0.02280 |
11/12/04 |
ISOSORBIDE DINITRATE |
TABLET |
20MG |
$0.05580 |
11/12/04 |
NIFEDIPINE |
CAPSULE |
10MG |
$0.67050 |
11/12/04 |
NYSTATIN 60ML |
ORAL SUSP |
100MU/ML |
$0.27333 |
11/12/04 |
PERPHENAZINE |
TABLET |
4MG |
$0.94170 |
11/12/04 |
METHOCARBAMOL |
TABLET |
500MG |
$0.14630 |
11/12/04 |
SOTALOL HCL |
TABLET |
80MG |
$1.78500 |
11/12/04 |
SOTALOL HCL |
TABLET |
120MG |
$2.35500 |
11/12/04 |
SOTALOL HCL |
TABLET |
160MG |
$2.92500 |
11/12/04 |
SOTALOL HCL |
TABLET |
240MG |
$3.97500 |
11/12/04 |
PLEASE MAKE THE FOLLOWING CHANGES TO THE APPENDIX C:
LABELER |
COMPANY |
BEGIN |
END |
00409 |
HOSPIRA, INC |
01/01/05 |
|
10572 |
AFFORDABLE PHARMACEUTICALS, LLC |
01/01/05 |
|
10631 |
RANBAXY LABORATORIES INCORPORATED |
01/01/05 |
|
17474 |
TYCO HEALTHCARE GROUP/KENDALL DIVISION |
|
01/01/05 |
50907 |
FEI WOMEN'S HEALTH LLC |
01/01/05 |
|
59063 |
KIEL LABORATORIES, INC |
01/01/05 |
|
64253 |
MEDEFIL, INC |
|
01/01/05 |
67425 |
ISTA PHARMACEUTICALS |
01/01/05 |
|
67707 |
OSCIENT PHARMACEUTICALS CORPORATION |
01/01/05 |
|
68012 |
SANTARUS, INC. |
01/01/05 |
|
PLEASE
FILE ADJUSTMENTS FOR CLAIMS WHICH MAY HAVE BEEN INCORRECTLY PAID
ATTENTION ALL PROVIDERS: THE LA MEDICAID RECIPIENT
ELIGIBILITY VERIFICATION SYSTEMS (REVS, MEVS, E-MEVS, AND PROVIDER RELATIONS)
ARE CHANGING EFFECTIVE 11/27/04. NOTIFICATION OF THESE CHANGES WAS PREVIOUSLY
DISTRIBUTED TO PROVIDERS THROUGH NEWSLETTERS, RA STUFFERS, TRAINING MATERIALS,
ETC. PLEASE BE AWARE OF THESE CHANGES WHEN ACCESSING THESE SERVICES AFTER
11/27/04.
ATTENTION ALL DENTAL PROVIDERS
MEDICAID HAS IMPLEMENTED THE PROGRAMMING CHANGES REQUIRED TO PAY PRIMARY
TOOTH AMALGAMS AT THE NEW RATE THAT WAS EFFECTIVE FOR DATES OF SERVICE ON OR AFTER SEPTEMBER 1, 2004. IN THE NEAR FUTURE, MEDICAID WILL
AUTOMATICALLY RECYCLE CLAIMS FOR PRIMARY TOOTH AMALGAMS IN ORDER TO CORRECT PROVIDER PAYMENTS. THESE TRANSACTIONS WILL APPEAR ON YOUR
REMITTANCE ADVICE. SHOULD YOU HAVE ANY QUESTIONS, PLEASE CONTACT UNISYS
PROVIDER RELATIONS BY CALLING (800)473-2783 OR (225)924-5040.
NOTICE TO PROVIDERS OF PROFESSIONAL SERVICES
THE 2004 CPT CODES HAVE BEEN LOADED TO OUR FILES AND MAY BE BILLED WITH
THE EFFECTIVE DATE OF SERVICE 01-01-2004. PROVIDERS MAY NOW SUBMIT CLAIMS FOR MEDICAID COVERED 2004 CODES.
THE 2004 PROFESSIONAL FEE SCHEDULE CAN BE FOUND ON OUR WEBSITE @
LAMEDICAID.COM.