Prescribers can submit their requests to Humana Clinical Pharmacy Review (HCPR) in the following ways: Electronic requests: Cover My Meds® is a free service that allows prescribers to submit and check the status of prior authorization requests electronically for any Humana plan. You can access this service directly (registration required) or review the flyer below for details. Plaquenil for cutaneous lupus Plaquenil reviews for uctd DRAFT PA Criteria Page 1 of 5 Initial Approval Date July 10, 2019 Revised Dates October 9, 2019 CRITERIA FOR PRIOR AUTHORIZATION Adult Rheumatoid Arthritis Agents BILLING CODE TYPE For drug coverage and provider type information, see the KMAP Reference Codes webpage. MANUAL GUIDELINES Prior authorization will be required for all current and future dose forms available. Reviews for self-administered specialty drugs if AllianceRx Walgreens Prime is the dispensing pharmacy. Specialty medications intended to be filled by Caremark Specialty pharmacy should not be requested through CoverMyMeds. Use the Caremark Specialty enrollment form to begin the PA process for those cases. Blue Cross and Blue Shield of Nebraska and Prime Therapeutics offer new Medicare Advantage Benefit OTC discount card. Quarterly discount card, covering 90,000 over-the-counter health aids and wellness products, helps seniors make better health choices easier, more affordable. Prescriber quick reference guide: This guide helps prescribers determine which Humana medication resource to contact for prior authorization, step therapy, quantity limits, medication exceptions, appeals and claims. Fax requests: Complete the applicable form and fax it to 1-877-486-2621. Plaquenil thru prime therapeutics Coverage and cost, Prior Authorization Program Information Accidental double dose of plaquenil Due to the national surge in health related Over-The-Counter ordering, certain OTC products are shipping slower than normal. We will continue to use fair share allocation of OTC product to combat shortages and strive to get orders out in a timely manner. Hydroxychloroquine 200 mg Tablets Generic Plaquenil. Prime Therapeutics. Pharmacy - Blue Cross and Blue Shield of Texas. Front-line healthcare personnel in the United States should be prepared to evaluate patients for coronavirus disease 2019 COVID-19. The following checklist from the CDC highlights key steps for healthcare personnel in preparation for transport and arrival of patients with confirmed or possible COVID-19. PLAQUENIL. HYDROXYCHLOROQUINE - ORAL. Important Note. The following information is intended to supplement, not substitute for, the expertise and judgment of your physician, pharmacist or other healthcare professional. It should not be construed to indicate that use of the drug is safe, appropriate, or effective for you. Consult your healthcare. Jan 04, 2019 On January 1, 2019, Blue Cross and Blue Shield of Texas BCBSTX implemented a new opioid drug management program to promote the safe and effective use of prescription opioids for our Blue Cross Medicare Advantage Part D plans members who have prescription drug benefits administered through Prime Therapeutics SM.