Brand/Generics
bevacizumab
What is Avastin?
J0178
What is Eylea?
Medical Supplies and Durable Medical Equipment
What is Send to Another Internal Channel?
Status Reason
What is B-Auto Approved?
Benefit SAD list drug is covered under Part ___
What is Part D?
Neulasta
What is pegfilgrastim?
J0585
What is Botox?
Bundled Drug Requests and the member is on Dialysis
What is B – Precert Not Required ?
DOA of injectable/IV drug
What is 6 months?
Denial for member is MA only plan with no PDP standalone for SAD list drug
What is administrative denial?
Prolia
What is denosumab?
Q5111
What is Udenyca?
Claim Reimbursement for a service which has already been provided
What is Returned to MDO?
This drug is considered non-NPL for ocular indications
What is Avastin?
Enbrel is on the SAD list for which states
What is all states?
Remicade
What is infliximab?
J9271
What is Keytruda?
Influenza and Pneumonia Vaccines
What is B-Precert Not Required?
non-NPL request must meet ALL of the following criteria: med is categorized as a drug or biologic by FDA, med is not used for cosmetic or contraceptive reasons, and is an ________
What is injectable drug?
True or False: Simponi Aria is on SAD list
What is FALSE?
nivolumab
What is Opdivo?
J9358
What is Enhertu?
Too soon to initiate
What is Invalid Request/Case not Required?
Durolane, Euflexxa, Synvisc, Synvisc-One, Firmagon, Eligard, and Zarxio will be removed from the NPL on this date
What is 10/1/2024?
True or False: SAD list applies for all routes of administration
What is FALSE?