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Medical Drug Benefit

December 4, 2024 / by Health Plan / Uncategorized

The medical drug benefit covers drugs that your doctor carries within their office. Your doctor will have purchased these drugs and the term for it is “Buy and Bill.” Drugs on the medical benefit may have limits or criteria that restrict its use to certain diseases, quantities, or drugs that have been tried and failed. [...]

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Medical Benefit Updates Table

June 29, 2022 / by Health Plan / Uncategorized

      Code Description PA Coverage Criteria J9144 INJECTION, DARATUMUMAB, 10MG AND HYALURONIDASE-FIHJ Approval is determined by medical necessity criteria Q5108 INJECTION, PEGFILGRASTIMJMDB, BIOSIMILAR, (FULPHILA), 0.5 MG   Q5110 INJECTION, FILGRASTIM-AAFI, BIOSIMILAR, (NIVESTYM), 1 MCG   Q5111 INJECTION, PEGFILGRASTIMCBQV, BIOSIMILAR, (UDENYCA), 0.5 MG   Q5101 INJECTION, FILGRASTIM-SNDZ, BIOSIMILAR, (ZARXIO), 1 MCG   J1447 INJECTION, […]

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Irbesartan & Irbesartan/Hctz Recall – IMMEDIATE ACTION NEEDED Table

June 29, 2022 / by Health Plan / Uncategorized

        Product Lot No NDC Distribution Dates Irbesartan Tablets USP, 75mg H000843, H805727, H901579 68180-410-06(30’s 10/20/2018 12/03/2020   H000844, H000964, H804311, H805267, H805268, H805269, H805725, H805726, H901497, H901577, H901578, H902258 68180-410-09(90’s   Irbesartan Tablets USP, 150mg H804403, H805251, H805640, H901580 68180-411-06(30’s     H804492, H805252, H805253, H805641, H805642, H805643, H901581, H902139, H902140 […]

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