RXBIN: 004336

RXPCN: MEDDADV

RXGRP: RXCVSD

The generic for Xopenex HFA Inhalation Aerosol recently became available in the marketplace; however, effective October 21, 2016, SilverScript will continue to cover the brand name Xopenex HFA at the Preferred Brand Tier.

The generic (levalbuterol tartrate HFA inhalation aerosol) will NOT be covered for SilverScript plan members. Please continue to dispense Xopenex HFA as prescribed rather than substituting the generic. If claims for the generic are submitted, the following reject will occur:

Reject 70 <<Dispense Brand – Xopenex HFA>>

If you need assistance, call the Pharmacy Help Desk at 1-866-693-4620.

Note: This does not apply to SilverScript Employer PDP plans.

Inside this issue of Express Scripts Network Pharmacy Weekly, you will find the following:

• Express Formulary Changes
• Anthem Refills Allowed Limits
• Anthem Pharmacy Home Program

*Please see attached PDF for more information.

OptumRx will be performing scheduled maintenance to our claim processing system on Saturday, October 22 from 8:30p.m. (PT) until 10:00 p.m. (PT) Saturday, October 22. Actual maintenance time required for this outage may be reduced, at which point OptumRx will resume processing claims and other functions earlier.

Pharmacies will be unable to process claims during the scheduled outage. The Pharmacy Help Desk will not be able to answer eligibility or benefit questions during this down time. We apologize for any inconvenience this may cause.

TO REDUCE PROCESSING ERRORS, PLEASE CONFIRM THE INFORMATION ON MEMBER’S ID CARD PRIOR TO SUBMITTING PRESCRIPTION CLAIMS.

Should you have any questions or require assistance, please contact the OptumRx Help Desk, 24 hours a day, 7 days a week:

Dear Valued Provider,

Please be advised that Flu and Pneumonia Vaccines are covered for Florida Blue Medicare Advantage Part B Covered Persons when administered at a Participating Pharmacy. Please see the attached PDF for further processing instructions.



If you have any questions about claims processing, please call the Prime Contact Center at 888.877.6323 for Commercial and 888.877.6420 for Medicare.  

Sincerely,

Pharmacy Network Management
Prime Therapeutics LLC

Prime Therapeutics Contracting Fax number: 877-823-6373

In this week's Generic News, there's a new Generics Campaign, as well as an updated list of FDA drug shortages, discontinuations, information from PruGen, and two new launches.