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PHARMACY COVERAGE GUIDELINES
SECTION:
DRUGSORIGINAL EFFECTIVE DATE:
LAST REVIEW DATE:
LAST CRITERIA REVISION DATE:
ARCHIVE DATE:8/02/18
8/15/19
8/15/19LUCEMYRA (lofexidine hydrochloride) oral tablet
Coverage
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What is lucemyra - blue cross?
Lucemyra - Blue Cross is a medication used to help manage the symptoms of opioid withdrawal.
Who is required to file lucemyra - blue cross?
Healthcare providers are required to prescribe and administer Lucemyra - Blue Cross.
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Lucemyra - Blue Cross should be filled out according to the prescribing information provided by the manufacturer.
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The purpose of Lucemyra - Blue Cross is to alleviate the symptoms of opioid withdrawal.
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Information such as dosage, frequency of administration, patient information, and prescribing healthcare provider should be reported on Lucemyra - Blue Cross.
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