Get the free OH ABD SSB Humira PAB Fax Form 12.03.06.doc
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CONTAINS CONFIDENTIAL PATIENT INFORMATION Ohio ABD Program Humor? (golimumab) Prior Authorization of Benefits (PAB) Form FAX TO PRIOR AUTHORIZATION OF BENEFITS CENTER AT (888) 382 5931 1. PATIENT
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How to fill out oh abd ssb humira
How to fill out oh abd ssb humira?
01
Make sure to wash your hands thoroughly before handling the medication.
02
Remove the pre-filled syringe from the packaging.
03
Inspect the syringe for any visible signs of damage or particles. If any are found, do not use the syringe and contact your healthcare provider.
04
Choose an injection site, such as the thighs or abdomen, and clean the area with an alcohol swab.
05
Hold the syringe with the cap pointing up and remove the cap.
06
Without touching the needle, push the plunger until the air bubble is gone and a drop of Humira appears at the tip.
07
Pinch the skin at the injection site and insert the needle at a 45- or 90-degree angle depending on your healthcare provider's instructions.
08
Slowly push the plunger all the way down to deliver the medication.
09
Once the injection is complete, remove the needle from the skin and activate the safety guard by pushing it against a flat surface until it clicks.
10
Dispose of the used syringe in a puncture-proof container.
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Individuals diagnosed with certain autoimmune disorders such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Crohn's disease, ulcerative colitis, or plaque psoriasis may be prescribed oh abd ssb humira.
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