RA Messages for March 11, 2003
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 1/01/02 VERSION OF APPENDIX A:
| DRUG |
DOSAGE |
STRGTH |
MAC |
EFF DATE |
| ALBUTEROL |
AEROSOL |
90MCG |
$0.88230 |
03/11/03 |
| AMITRIPTYLINE HCL |
TAB |
10MG |
$0.06080 |
03/11/03 |
| AMITRIPTYLINE HCL |
TAB |
25MG |
$0.06530 |
03/11/03 |
| AMITRIPTYLINE HCL |
TAB |
75MG |
$0.14250 |
03/11/03 |
| CAPTOPRIL/HCTZ |
TAB |
25-25MG |
$0.23600 |
03/11/03 |
| CEFADROXIL MONOHYDRATE |
CAP |
500MG |
$2.48370 |
03/11/03 |
| CLONIDINE HCL |
TAB |
0.1MG |
$0.09680 |
03/11/03 |
| CLONIDINE HCL |
TAB |
0.3MG |
$0.17940 |
03/11/03 |
| CLONIDINE HCL |
TAB |
0.2MG |
$0.13500 |
03/11/03 |
| DESOXIMETASONE 60GM |
CREAM |
0.25% |
$0.61800 |
03/11/03 |
| DEXAMETHASONE |
ELIXIR |
0.5MG/5ML |
$0.06250 |
03/11/03 |
| FOLIC ACID |
TAB |
1MG |
$0.04650 |
03/11/03 |
| FUROSEMIDE |
TAB |
80MG |
$0.10430 |
03/11/03 |
| GEMFIBROZIL |
TAB |
600MG |
$0.26850 |
03/11/03 |
| GLYBURIDE |
TAB |
1.25MG |
$0.12440 |
03/11/03 |
| GLYBURIDE |
TAB |
2.5MG |
$0.18930 |
03/11/03 |
| GLYBURIDE |
TAB |
5MG |
$0.28310 |
03/11/03 |
| HYDRALAZINE HCL |
TAB |
25MG |
$0.05190 |
03/11/03 |
| HYDROCORTISONE 120ML |
LOTION |
1% |
$0.05720 |
03/11/03 |
| HYDROXYZINE PAMOATE |
CAP |
25MG |
$0.08920 |
03/11/03 |
| IMIPRAMINE HCL |
TAB |
10MG |
$0.32100 |
03/11/03 |
| IMIPRAMINE HCL |
TAB |
25MG |
$0.42750 |
03/11/03 |
| IMIPRAMINE HCL |
TAB |
50MG |
$0.56150 |
03/11/03 |
| LISINOPRIL |
TAB |
2.5MG |
$0.38550 |
03/11/03 |
| LISINOPRIL |
TAB |
5MG |
$0.57830 |
03/11/03 |
| LISINOPRIL |
TAB |
10MG |
$0.59700 |
03/11/03 |
| LISINOPRIL |
TAB |
20MG |
$0.63900 |
03/11/03 |
| LISINOPRIL |
TAB |
30MG |
$0.90380 |
03/11/03 |
| LISINOPRIL |
TAB |
40MG |
$0.93450 |
03/11/03 |
| LISINOPRIL/HCTZ |
TAB |
10-12.5MG |
$0.64500 |
03/11/03 |
| LISINOPRIL/HCTZ |
TAB |
20-12.5MG |
$0.69830 |
03/11/03 |
| LISINOPRIL/HCTZ |
TAB |
20-25MG |
$0.70650 |
03/11/03 |
| METHYLPREDNISOLONE |
TAB |
4MG |
$0.28490 |
03/11/03 |
| METRONIDAZOLE |
TAB |
250MG |
$0.08490 |
03/11/03 |
| NAPROXEN |
TAB |
500MG |
$0.18050 |
03/11/03 |
| NIZATIDINE |
CAP |
150MG |
$1.83070 |
03/11/03 |
| NIZATIDINE |
CAP |
300MG |
$3.66150 |
03/11/03 |
| OXAZEPAM |
CAP |
30MG |
$1.23085 |
03/11/03 |
| PENICILLIN V POTASSIUM 200ML |
SUSP |
250MG/5ML |
$0.02535 |
03/11/03 |
| PREDNISONE |
TAB |
5MG |
$0.06405 |
03/11/03 |
| PREDNISONE |
TAB |
10MG |
$0.06760 |
03/11/03 |
| PREDNISONE |
TAB |
20MG |
$0.11770 |
03/11/03 |
| PROPRANOLOL HCL/HCTZ |
TAB |
40-25MG |
$0.08770 |
03/11/03 |
| PROPRANOLOL HCL/HCTZ |
TAB |
80-25MG |
$0.13200 |
03/11/03 |
| QUINIDINE GLUCONATE |
TAB SA |
324MG |
$0.50550 |
03/11/03 |
| SULINDAC |
TAB |
150MG |
$0.33170 |
03/11/03 |
| SULINDAC |
TAB |
200MG |
$0.42890 |
03/11/03 |
| THEOPHYLLINE ANHYDROUS |
TAB |
300MG |
$0.30020 |
03/11/03 |
| THIORIDAZINE HCL |
TAB |
10MG |
$0.21900 |
03/11/03 |
| THIORIDAZINE HCL |
TAB |
25MG |
$0.30300 |
03/11/03 |
| THIORIDAZINE HCL |
TAB |
100MG |
$0.50250 |
03/11/03 |
| THIOTHIXENE |
CAP |
1MG |
$0.13880 |
03/11/03 |
| TIZANIDINE |
TAB |
2MG |
$0.80710 |
03/11/03 |
| TIZANIDINE |
TAB |
4MG |
$0.95600 |
03/11/03 |
| TRAMADOL |
TAB |
50MG |
$0.30680 |
03/11/03 |
| TRIAMCINOLONE ACETONIDE |
PASTE |
0.1% |
$1.87800 |
03/11/03 |
| TRIAMCINOLONE ACETONIDE 60ML |
LOTION |
0.1% |
$0.17033 |
03/11/03 |
| VALPROIC ACID |
CAP |
250MG |
$0.34880 |
03/11/03 |
| VERAPAMIL HCL |
TAB |
80MG |
$0.07350 |
03/11/03 |
| VERAPAMIL HCL |
TAB |
120MG |
$0.11100 |
03/11/03 |
| VERAPAMIL HCL |
TAB |
240MG |
$0.36830 |
03/11/03 |
PLEASE FILE
ADJUSTMENTS FOR CLAIMS WHICH MAY HAVE BEEN INCORRECTLY PAID
ATTENTION ALL PROVIDERS
THE PROVIDER ENROLLMENT UNIT HAS A NEW PHONE NUMBER. IT IS
225-237-3370.
ATTENTION HOME AND COMMUNITY BASED WAIVER SERVICES
FOR INFORMATION ABOUT HOME AND COMMUNITY BASED WAIVER SERVICES
AS AN ALTERNATIVE LONG TERM CARE OPTION, PLEASE CALL 1-800-660-0488.
ATTENTION AMBULANCE, PROFESSIONAL, WAIVER, AND DME
PROVIDERS
IT HAS COME TO OUR ATTENTION THAT AMBUALNCE CLAIMS ELECTRONICALLY
SUBMITTED BETWEEN 02/10-21/03 WERE DENIED IN ERROR FOR EDIT 232- PROCEDURE/ TYPE OF SERVICE NOT COVERED.ADDITIONALLY,PROFESSIONAL/DME/WAIVER CLAIMS
SUBMITTED HARDCOPY BETWEEN 12/05/02 & 02/21/03 WERE ZERO PAID IN ERROR. THE CAUSE OF THESE DENIALS AND ZERO PAYMENTS HAS BEEN IDENTIFIED AND
CORRECTED. ALL AFFECTED CLAIMS FOR THESE PROGRAMS DURING THESE TIME PERIODS ARE BEING RECYCLED TO APPEAR ON YOUR RA OF 03/10/03. QUESTIONS
MAY BE DIRECTED TO UNISYS PROVIDER RELATIONS - 800/473-2783.