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.
DRUG |
DOSAGE |
STRENGTH |
MAC |
EFF DATE |
ALBUTEROL SULFATE |
TABLET |
2MG |
0.28244 |
12/01/02 |
ALBUTEROL SULFATE |
TABLET |
4MG |
0.41375 |
12/01/02 |
AMANTADINE HCL |
CAPSULE |
100MG |
0.35697 |
12/01/02 |
ATENOLOL |
TABLET |
25MG |
0.15950 |
12/01/02 |
ATENOLOL |
TABLET |
50MG |
0.08850 |
12/01/02 |
ATENOLOL |
TABLET |
100MG |
0.16500 |
12/01/02 |
BACLOFEN |
TABLET |
10MG |
OFF MAC |
12/01/02 |
BACLOFEN |
TABLET |
20MG |
OFF MAC |
12/01/02 |
BENZTROPINE MESYLATE |
TABLET |
0.5MG |
0.12270 |
12/01/02 |
BENZTROPINE MESYLATE |
TABLET |
1MG |
0.15020 |
12/01/02 |
BENZTROPINE MESYLATE |
TABLET |
2MG |
0.19300 |
12/01/02 |
BUSPIRONE HCL |
TABLET |
5MG |
0.29640 |
12/01/02 |
BUSPIRONE HCL |
TABLET |
10MG |
0.39420 |
12/01/02 |
BUSPIRONE HCL |
TABLET |
15MG |
0.44700 |
12/01/02 |
DOXYCYCLINE HYCLATE |
CAPSULE |
50MG |
0.09150 |
12/01/02 |
DOXYCYCLINE HYCLATE |
TABLET |
100MG |
0.12870 |
12/01/02 |
ETODOLAC |
TABLET |
400MG |
0.36000 |
12/01/02 |
FLUOXETINE HCL |
CAPSULE |
10MG |
0.58500 |
12/01/02 |
FLUOXETINE HCL |
CAPSULE |
20MG |
0.60000 |
12/01/02 |
FLUOXETINE HCL |
CAPSULE |
40MG |
4.01250 |
12/01/02 |
FLUOXETINE HCL |
SOLUTION |
20MG/5ML |
0.75000 |
12/01/02 |
FLUOXETINE HCL |
TABLET |
10MG |
0.60000 |
12/01/02 |
HYDROXYZINE PAMOATE |
CAPSULE |
100MG |
OFF MAC |
12/01/02 |
LOVASTATIN |
TABLET |
10MG |
0.74870 |
12/01/02 |
LOVASTATIN |
TABLET |
20MG |
1.24880 |
12/01/02 |
LOVASTATIN |
TABLET |
40MG |
2.37380 |
12/01/02 |
METRONIDAZOLE |
TABLET |
500MG |
0.21840 |
12/01/02 |
NYSTATIN |
ORAL SUSP |
100MU/ML |
0.17570 |
12/01/02 |
OXAPROZIN |
TABLET |
600MG |
0.67580 |
12/01/02 |
SELENIUM SULFIDE |
SHAMP/LOT |
2.5% |
0.05191 |
12/01/02 |
SULFAMETHOXAZOLE/TRIMETH |
ORAL SUSP |
200/40MG/5 |
0.03295 |
12/01/02 |
THEOPHYLLINE ANHYDROUS |
TAB SR 12H |
100MG |
0.11840 |
12/01/02 |
THIORIDAZINE
HCL |
TABLET |
50MG |
0.38850 |
12/01/02 |
PLEASE FILE ADJUSTMENTS FOR
CLAIMS WHICH MAY HAVE BEEN INCORRECTLY PAID.
CORRECTIVE MESSAGE- NOTICE TO ALL PROVIDERS
THE PREVIOUSLY PUBLISHED SCHEDULE FOR THE EXPANSION OF THE COMMUNITYCARE
PROGRAM IN 2003 HAS BEEN CHANGED. THE REVISED COMMUNITYCARE IMPLEMENTATION SCHEDULE FOR 2003 IS AS FOLLOWS:
MARCH 2003 - ACADIA, EVANGELINE, IBERIA, LAFAYETTE, ST. LANDRY, ST. MARTIN, AND VERMILION
JUNE 2003 - BOSSIER, CADDO, CALDWELL, FRANKLIN, LINCOLN, OUACHITA, AND TENSAS
SEPTEMBER 2003 - ORLEANS
DECEMBER 2003 - PLAQUEMINE, ST. BERNARD, JEFFERSON - EAST BANK AND JEFFERSON - WEST BANK
QUESTIONS REGARDING THIS MATTER MAY BE DIRECTED TO UNISYS PROVIDER
RELATIONS AT 1-800-473-2783.
ATTENTION PROVIDERS BILLING ELECTRONICALLY
PROVIDERS BILLING WITH THE EQUIVALENT OF HCFA 1500 SPECS NOW HAVE THE CAPABILITY OF SUBMITTING BOTH A PRIMARY AND A SECONDARY DIAGNOSIS FOR CLAIM TRANSMISSIONS. PREVIOUSLY ONLY A PRIMARY DIAGNOSIS COULD BE ENTERED IN THESE SPECS. IF NEEDED, PLEASE MAKE THE NECESSARY CHANGE TO YOUR SOFTWARE TO ALLOW SUBMISSION OF THE SECONDARY DIAGNOSIS AS IT IS NOW ACCEPTABLE BY UNISYS. MORE INFORMATION, INCLUDING A COPY OF THE REVISED HCFA 1500 SPECIFICATIONS, WILL BE PUBLISHED IN THE UPCOMING PROVIDER UPDATE. IF YOU NEED A COPY OF THE REVISED SPECS PRIOR TO THAT TIME, PLEASE HAVE YOUR SOFTWARE VENDOR CONTACT UNISYS EMC DEPARTMENT AT 225/237-3200.