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PHARMACY COVERAGE GUIDELINES
SECTION:
DRUGSORIGINAL EFFECTIVE DATE:
LAST REVIEW DATE:
LAST CRITERIA REVISION DATE:
ARCHIVE DATE:1/21/16
1/18/18
1/18/18KEVEYIS (dichlorphenamide) oral tablet
Coverage
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How to fill out keveyis - blue cross
How to fill out keveyis - blue cross
01
To fill out a Keveyis – Blue Cross form, follow these steps:
02
Obtain the Keveyis – Blue Cross form from your healthcare provider or from the Blue Cross website.
03
Start by filling out your personal information, including your name, address, and contact details.
04
Provide your insurance details, such as your policy number and group number.
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Clearly indicate the type of service or treatment for which you are seeking coverage.
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Who needs keveyis - blue cross?
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Keveyis - Blue Cross is typically needed by individuals who require coverage for Keveyis medication.
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Keveyis is a prescription medicine used to treat primary periodic paralysis, a rare genetic disorder characterized by episodes of muscle weakness or paralysis.
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Individuals diagnosed with primary periodic paralysis and prescribed Keveyis by their healthcare provider may seek coverage from Blue Cross.
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However, specific eligibility criteria and coverage options may vary depending on the insurance plan and policy.
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What is keveyis - blue cross?
Keveyis - blue cross is a medication used to treat periodic paralysis.
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Patients prescribed with keveyis - blue cross are required to file it with their insurance provider.
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