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Rx Updates
How many refills are allowed on Controlled Prescriptions?
- No Schedule III or IV prescriptions may be refilled more than 5 times and in an amount, for all refills of that prescription taken together, exceeding a 120-day supply
Correct Examples:
Alprazolam 1mg QD prn #30 with 4 refills
- (30-day supply + 120-day supply = 150-day supply total – 5 fills)
Alprazolam 1mg QD prn #20 with 5 refills
- (20-day supply + 100-day supply = 120 day supply total – 6 fills)
Albuterol Inhalers
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Request for Generic Prescription: Pharmacists kindly request that albuterol inhalers be prescribed using the generic term "albuterol" rather than brand names such as Ventolin, Proair, and others.
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Variability in Brand Name Inhalers: Brand name inhalers may vary in the quantity of albuterol they contain and pose challenges for insurance coverage purposes. Prescribing albuterol generically ensures consistency and facilitates smoother insurance processing.
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Streamlined Process: Choosing to prescribe albuterol inhalers generically means providers will not need to be contacted for changes.
Wegovy and Zepbound – Insurance Limitations: Many insurance plans will require a prior authorization for these weight loss medications. As of now, minimum requirements for treatment initiation: BMI ≥ 30, or ≥ 27 with weight-related comorbidity, need to have been enrolled in comprehensive weight loss program for 6 months within the past year. For continuation of therapy, health plans want to see a 5% weight loss from start weight and a comprehensive weight loss plan. For any P/A questions, please contact our Prior Authorization Coordinator, Staci Gongora at ext. 3477.
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