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Blockade (extended release) Pharmacy Restriction PRIOR REVIEW/CERTIFICATION FATBACK FORM INCOMPLETE FORMS MAY DELAY PROCESSING ALL NC PROVIDERS MUST PROVIDE THEIR 5DIGIT Blue Cross NC PROVIDER ID#

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What is sublocade extended release?

Sublocade extended release is a type of medication that is administered as an injection and is used to treat opioid use disorder.

Who is required to file sublocade extended release?

Healthcare providers who are authorized to prescribe medications such as Sublocade extended release are required to file the necessary documentation for its administration.

How to fill out sublocade extended release?

Sublocade extended release should be filled out by a qualified healthcare provider who follows the proper dosage and administration guidelines.

What is the purpose of sublocade extended release?

The purpose of Sublocade extended release is to provide a long-lasting dose of medication to help individuals manage their opioid use disorder.

What information must be reported on sublocade extended release?

Information such as the patient's medical history, current medications, dosage administered, and any side effects observed must be reported on the documentation for Sublocade extended release.

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