RA Messages for March 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
PLEASE MAKE THE FOLLOWING CHANGES TO THE 8/15/98 VERSION OF APPENDIX A:
| DRUG
|
DOSAGE |
STRGTH
|
MAC |
EFF.DATE |
| ALOSETRON HCL |
TABLET |
1MG |
|
02/28/00 |
| CICLOPIROX |
SOLUTION |
8% |
|
03/01/00 |
| CLONIDINE HCL |
VIAL |
500MCG/ML |
|
02/03/00 |
| DEXMEDETOMIDINE HCL |
VIAL |
200MCG/2ML |
|
02/21/00 |
| DIHY-COD TT/APAP/CAFF |
TABLET |
32-713-60 |
|
02/15/00 |
| LEVETIRACETAM |
TABLET |
250MG;500MG |
|
03/06/00 |
| LEVOBUPIVACAINE HCL |
VIAL |
2.5MG/ML;5MG/ML;7.5MG/ML |
|
03/03/00 |
| PALIVIZUMAB |
VIAL |
50MG |
|
02/02/00 |
| PORACTANT ALFA |
VIAL |
120MG/1.5ML;240MG/3ML |
|
02/14/00 |
| TERAZOSIN HCL |
TABLET |
1MG;2MG;5MG |
|
02/17/00 |
PLEASE FILE ADJUSTMENTS FOR CLAIMS WHICH MAY HAVE BEEN INCORRECTLY PAID