Which of these statements is NOT true about the drug utilization management (UM) rules?

Answers

Answer 1

Step treatment and the prior authorization quantity limit are two instances of the coverage rules.

What is drug utilization management (UM) rules?

The following are utilization management restrictions that your Medicare Part D (PDP) or Medicare Advantage plan (MAPD) may impose on your prescription medications: Limiting the amount of a specific medication you can receive in a set period of time.

Prior Authorization is the practice of forcing plan participants to get plan approval prior to filling a prescription.

Step Therapy is the practice of requiring plan participants to first try less expensive drugs (such generics) before switching to a more expensive one (usually a brand-name drug).

Any formulary drug offered by your Medicare drug plan may be subject to utilization management restrictions, and this list may change from year to year. If you continue to use the same drug plan the following year, you may discover that some of your formulary medications now fall under this category.

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Related Questions

muscle helps with mastication by compressing the cheek to move food over the teeth. it is also a primary muscle used by infants for sucking.

Answers

Muscles of mastication include the masseter, temporalis, medial pterygoid and lateral pterygoid.

The masseter is the main muscle used for:

Chewing While the temporalisMedial pterygoid and lateral pterygoid

All assist in moving the mandible, or lower jaw, to allow for mastication.

The Role of Muscles of Mastication in Chewing and Nutrition

The muscles of mastication are responsible for the action of chewing food. The primary muscle used for mastication is the masseter, which is located in the cheek region and is responsible for compressing the cheek to move food over the teeth. The temporalis, medial pterygoid, and lateral pterygoid muscles all work together to move the mandible, or lower jaw, to allow for mastication.

These muscles of mastication are also used by infants for sucking and are integral to the process of chewing and breaking down food. Without the ability to chew and break down food, it would be difficult to properly digest and absorb nutrients. Therefore, the muscles of mastication play an important role in digestion and nutrition.

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Keri eats seven hamburgers and five servings of French fries for lunch every single
day. She finishes her entire meal during the first 20 minutes of her lunch period and
uses the final 10 minutes to do jumping jacks which causes her to throw up what she
just ate. What does this scenario MOST LIKELY demonstrate?
anorexia nervosa
depression
bulimia nervosa
binge eating

Answers

Answer:

C.

Explanation:

bulimia nervosa

a disease of the mucous memberanes in which there may be interlacing white lines on the buccal mucosa, red gingiva and raise lesions in plaque-like configuration is termed

Answers

A disease of the mucous membranes in which there may be interlacing white lines on the buccal mucosa, red gingiva and raise lesions in plaque-like configuration is termed Oral lichen planus .

What is a mucous membrane disease ?Mucous membrane pemphigoid is an uncommon, chronic disease that causes blistering and scarring of the oral and ocular mucosa. The nasopharynx, larynx, genitalia, rectum, and esophagus are among the other mucosal areas that may be impacted. Scarring of the damaged mucosa of the eye may lead to blindness. A mix of environmental and genetic factors appear to have a role in the vulnerability of developing cicatricial pemphigoid. Although the precise etiology of this syndrome is unknown, it is thought to be an autoimmune disease defined by the development of autoantibodies against basement membrane zone antigens such as BP180, BP230, and laminin 5.Mucous membrane pemphigoid (MMP) is a category of rare chronic autoimmune illnesses defined by blistering lesions that mostly affect the various mucous membranes of the body. The mucous membranes of the mouth and eyes are most typically impacted. The nose, throat, genitalia, and anus mucous membranes may also be impacted.

What is oral lichen planus ?Oral lichen planus is a chronic inflammatory disorder affecting the mucous membranes of the mouth. The term "electronic commerce" refers to the sale of electronic goods. Alternatively, portions of your oral tissues may be bright red. Although oral lichen planus is not harmful, you may require medicine to alleviate your symptoms. Oral lichen planus (OLP) is a chronic inflammatory condition of the oral mucosa caused by T-cells. It has periods of symptomatic exacerbation and remission, and treatment focuses on lowering inflammation and giving symptomatic relief.

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Complete question is :

A disease of the mucous membranes in which there may be interlacing white lines on the buccal mucosa, red gingiva, and raised white lesions in plaque-like configurations is termed:

Select one:

A. Oral lichen planus

B. Primary herpetic gingivostomatitis (PHG)

C. Gingival disease of specific bacterial origin

D. Erythema multiforme

Dr. Strangelove performs a study evaluating the effect of different perfumes on feelings of attraction.In this study, the different perfume types are the ________________ variable.

Answers

Answer:

Independent variable

Explanation:

An independent variable is the variable that is changed or controlled in a scientific experiment to test the effects on the dependent variable. A dependent variable is the variable being tested and measured in a scientific experiment

The dependent variable is feeling's of attraction

Hope this helps

Why are there large numbers of lymph nodes in the axillary and inguinal regions?

Answers

to defend against bacteria and foreign invaders because this is where peripheral lymphatics connect with the trunk.

It's responsibility of all to stop STDs. Mention one reason.​

Answers

Answer:

While many STDs can be cured or treated with medication, the consequences of untreated STDs can include: infertility, pregnancy complications, cervical cancer, pelvic inflammatory disease, birth defects and a 3- to 5-fold increased risk of HIV transmission.

Ray is a nursing student working on a spreadsheet for class. He keeps getting error messages when entering his data and trying to make formulas work. He turns to his roommate, Jacques, in frustration. Ray knows spreadsheets have a variety of uses in nursing and have been adopted in the delivery of nursing care, so he needs to master them. Jacques proceeds to help Ray with the issue, educating him about spreadsheets in the process (Learning Objective 4).Please cite page reference in text for your answer.
a. What are the common quantitative errors associated with spreadsheets that Jacques should mention to Ray?
b. What cause and methods should Jacques mention Ray could use to manage these errors?

Answers

Answer:

Creating several tables within the same worksheet or spreadsheet. The computer assumes an erroneous association between these tables. So Ray ought to avoid doing thatMerging Cells. This usually creates problems when its time for analysis. Entering multiple data into one cell. For example, stating 1 MB (One Mercedes Benz) and 3 LX (three Lexus cars). If you try summing both cells, you'd realise that it will errors.

Solution:

Separate tables into difference worksheets and reference them where necessary. Excel can hold at least 255 worksheets. I doubt that you'd need that much.To check that you don't have any merged cells, first, save a copy of the master file then modify one the copies by highlighting the affected worksheets then use the unmerge function to remove any merged formatting. Thereafter, trace all relevant cells to ensure data consistency.With regard to different kinds of data, ensure you enter them in separate cells. That way Excel will understand better what you are trying to process.

Cheers

Can I pls have a paragraph on anorexia?
8 sentences long
Answers that are copied will be deleted......copying isn't allowed on brainly :)
I will also check to make sure the answers are not copied before giving brainliest.

Answers

Answer:

Hey there, I will be more than happy to write you a paragraph.

     What is anorexia? Anorexia nervosa is an eating disorder causing people to obsess about weight and what they eat. Anorexia is characterized by a distorted body image, with an unwarranted fear of being overweight. Symptoms of anorexia are extreme weight loss or not making expected developmental weight gains . thin appearance . abnormal blood counts . fatigue , and insomnia.  Things that anorexia can cause is anemia., heart problems, such as mitral valve prolapse, abnormal heart rhythms or heart failure , bone loss (osteoporosis), increasing the risk of fractures , loss of muscle , absence of a period , decreased testosterone , gastrointestinal problems, such as constipation, bloating or nausea , electrolyte abnormalities, such as low blood potassium, sodium and chloride , kidney problems. If a person with anorexia becomes severely malnourished, every organ in the body can be damaged, including the brain, heart and kidneys. This damage may not be fully reversible, even when the anorexia is under control. Anorexia is extremely dangerous and can be fatal. There's no guaranteed way to prevent anorexia nervosa. Primary care physicians (pediatricians, family physicians and internists) may be in a good position to identify early indicators of anorexia and prevent the development of full-blown illness. For instance, they can ask questions about eating habits and satisfaction with appearance during routine medical appointments.

Explanation:

Hope this helps!! Please consider marking brainliest! Have a good one!!

Cited sources: Mayo clinic

Look here at this wonderful thing?

Look here at this wonderful thing?

Answers

Answer:

oh okay .

Explanation:

brainliest please >?

Answer:

yummy points

Explanation:

here is a cat yawning

Look here at this wonderful thing?

Use your knowledge of argument forms and the counterexample method to determine which, if any, of the following statements are true.

a. If you can give a substitution instance with true premises and a false conclusion, then this will show that an argument form is invalid.
b. In the form for a hypothetical syllogism, the letters represent noun phrases.
c. To be a counterexample, a substitution instance must use terms or statements that begin with the same letters as those in the argument form of which it is an instance.
d. All invalid arguments are substitution instances of the same form.
e. In all argument forms, the letters represent statements.
f. A single counterexample is enough to prove that an argument or an argument form is invalid.
g. A counterexample can demonstrate why the conclusion of an argument does not follow by necessity from the argument's premises.

Answers

Answer:

a and c

Explanation:

Answer:

A, C, and G

Explanation:

If you can prove something with evidence it can prove something is either true or false.

Silica exposure in the form of dust particles is only harmful if the worker is exposed to it for long periods of time.
True
False

Answers

true

Explanation:

because it is harmful for anyone who takes it in

Silica exposure in the state of dust particles is only dangerous if the worker is exposed to it for long periods of time. Therefore,  the given statement is true.

Silica is also known as silicon dioxide. It is a naturally occurring mineral commonly found in rocks, sand, and soil. It is used in a variety of industries, including construction, manufacturing, and cosmetics.

While silica itself is generally considered safe, prolonged exposure to crystalline silica dust can have harmful health effects. Long-term exposure to respirable crystalline silica dust can lead to a lung disease called silicosis.

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Which part of the skeletal system makes up the limbs? appendicular skeleton axial skeleton

Answers

Answer:

Your axial skeleton is made up of the bones in your head, neck, back, and chest. Your appendicular skeleton is made up of everything else — the bones that attach (append) to your axial skeleton. Your appendicular skeleton includes the bones in your shoulders, pelvis, and limbs, including your arms, hands, legs, and feet.

Explanation:

I gotchuuuuuu

Assess effective administrators in Early childhood programs

Answers

Effective administrators in early childhood programs are critical to the success of the program. The administrator is responsible for providing a safe, nurturing, and enriching environment for children while also ensuring compliance with local and state regulations.

Effective administrators possess several characteristics that enable them to run a successful early childhood program.Firstly, effective administrators in early childhood programs have strong leadership skills. They have the ability to inspire, motivate, and guide staff to provide the best possible care for children. Effective administrators are also excellent communicators. They listen actively and communicate effectively with parents, staff, and community members.Secondly, effective administrators in early childhood programs are knowledgeable about child development. They have a deep understanding of the developmental stages of young children and use that knowledge to create a curriculum that is developmentally appropriate and engaging for children.Thirdly, effective administrators in early childhood programs are organized and detail-oriented. They are responsible for ensuring compliance with local and state regulations, maintaining accurate records, and managing budgets and resources effectively. Effective administrators prioritize safety and take all necessary precautions to ensure the physical safety and emotional well-being of children.

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Reasons why women attend antenatal clinics

Answers

The purpose of antenatal care is to ensure that a woman has a safe pregnancy and that does not mean absence of any disease during this period.
Women attending antenatal clinics plays a crucial role in promoting maternal and fetal health, facilitating early detection and management of complications, and empowering women with knowledge and support throughout their pregnancy.

Scrubs donned by hospital staff are considered to be

Answers

Answer:

I believe it is considered to be a sterile technique.

Explanation:

Which one of the following uses a mental "file" of calming images when you're in
stressful situations?
Alternative imagery
Productive imagery
Guided imagery
Collective imagery

Answers

Answer: Guided imagery uses a mental “file” of calming images when you're in stressful situations.

Explanation:

Guided imagery uses Relaxing thoughts and images to replace disturbing thoughts, allowing your brain to calm itself. guided imagery can make you feel like you are experiencing something just by imagining it. This can lower blood pressure and reduce other problems related to stress.

Responsible Service of Alcohol

Answers

Answer:

Responsible Service of Alcohol (RSA) is a legal requirement under s73 of the Liquor Act that ensures that licensees and staff understand their obligations in selling and providing alcohol responsibly.

Use all of the information you have learned thus far to create a ONE DAY HEALTHY eating plan.

Your plan should be based on the number of calories recommended by the USDA based on your age, weight, height and activity level.

Your plan should include the correct balance of the food groups and the correct balance of whole grains, vegetables, oils, and meats as suggested by the USDA.

When creating your plan, keep the following in mind:

You should eat three small meals a day with small snacks in between each meal.
You should consume 6-8 glasses of water each day.
Try to keep salt intake to a minimum.

Answers

A general healthy diet involves scrambled eggs during breakfast, grilled chicken during lunch and salmon fillet in dinner.

Thus, a general healthy diet based on the recommended daily calorie intake involved breakfast with 2 slices of whole-grain bread, 2 scrambled eggs and 1 cup of skim milk. 1 small banana and handful of raw almonds should be taken before lunch. Lunch should be grilled chicken, brown rice and steamed broccoli.

After lunch, dinner should be baked salmon fillet, roasted sweet potato and sautéed spinach and before bedtime snack, drink unsweetened soy milk. 6-8 glasses of water should be recommended throughout the day. Healthy oils such as olive oil or avocado oil should be incorporated when cooking to have a healthy diet.

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When eating lean meats such as poultry one serving size is compared to a half of the dinner plate b a deck of cards c a ping pong ball d a quarter

Answers

the answer would be b a deck of cards because ping pong and quarter are far to small for the recommended serving size

Mrs. Wilson is brought into the ER after a car accident. A major artery in her leg has been damaged, and she lost an undetermined amount of blood before EMTs arrived and were able to stop the bleeding. What dangers might Mrs. Wilson be facing? How might she be treated?

Answers

Answer:

The dangers she might face are rapid blood loss, heart attack, stroke, and death. She might be treated by applying pressure on the injury.

Explanation:

In arterial bleeding, the arteries carry oxygenated blood away from the heart; so when bleeding it's in rapid spurts. The pressure inside the artery doesn't help, so there's rapid blood loss. This causes the oxygen supply in the body to decrease drastically. It can lead to stroke, heart attack, and death.

To prevent this, she might be treated by applying direct pressure on the wound using a clean, thick dressing to prevent more bleeding. Hold it in place and don't lift it to see if there's bleeding.

The arteries serve as passage along with blood reaches the body tissues, hence, a damage to the artery means that the passage has been disconnected and the would result into bleeding.

Mrs. Wilson will suffer rapid blood loss, organ failure due to shock as the person suffers due to the shortage in supply of oxygenated blood reaching the body tissue. If bleeding continues, it can lead to death.

To treat such person, the major attention should be on putting a stop to the bleeding. This can be achieved by applying pressure directly on the wound using clean clothes till the bleeding stops.

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food packaged on site dor retail sale in an operation must be labeled when the food

Answers

Answer:

Labeling food for use on-site:

All items not in their original containers must be labeled. Food labels should include the common name of the food or a statement that clearly and accurately identifies it. It is not necessary to label food if it clearly will not be mistaken for another item.

Why Food labelling is important?

Food labelling is one way in which consumers can get knowledge about the food they consider buying. Correctly following the information provided on food labels (such as expiry dates, handling instructions and allergy warnings) can help consumers prevent unnecessary food-borne illness and allergic reactions.Nutrition labels must display the amount of energy (calories and kilojoules) and the amount of fat, saturated fat, carbohydrates, sugars, proteins and salt (all expressed in grams) present in 100g (or 100 ml) of the food.

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food packaged on site dor retail sale in an operation must be labeled when the food

Tab Paracetamol 1g tds x 5/7. Available is 500mg

Answers

The medical abbreviation "TDS" stands for three times a day. The term "Tab" is an abbreviation for a tablet. 1g represents 1000mg.So, Tab Paracetamol 1g tds x 5/7 can be interpreted as "take one 1000mg

Paracetamol tablet three times a day for five to seven days". However, since 1000mg tablets of Paracetamol are not available and only 500mg tablets of Paracetamol are available, the prescription will be written as Tab Paracetamol 500mg TDS x 5/7.Tab Paracetamol 500mg TDS x 5/7 means to take one 500mg tablet of Paracetamol three times a day for five to seven days.

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Many active people, particularly competitive athletes, like to rest as long as recommended.

A) True

B) False

Answers

Answer:

A.

Explanation:

Answer: is A

If you're an athlete in training, you may need more. "Just as athletes need more calories than most people when they're in training, they need more sleep, too," Geier says. You're pushing your body in practice, so you need more time to recover. Athletes in training should sleep about an hour extra.

How might peer passengers negatively influence driving?
by encouraging speeding
by serving as good copilots
by keeping their voices down
by helping the driver pay for gas

Answers

Answer:

Explanation:

Encouraging speeding

What’s makes all drugs similar

Answers

Similarities of all drugs.

RoosterBRAWLS

What’s makes all drugs similar

All drugs, regardless of their specific chemical structure or intended use, share certain common characteristics that make them similar. Here are some of the key similarities:

They all alter the normal functioning of the body: Drugs are designed to affect the body's biochemistry in some way, whether by inhibiting or enhancing the activity of certain enzymes, receptors, or neurotransmitters.

They all have potential side effects: Because drugs interfere with the body's natural processes, they can also cause unintended effects. These can range from mild (such as drowsiness or nausea) to severe (such as organ damage or addiction).

They all require careful dosing and administration: To achieve the desired therapeutic effect, drugs must be given in the right dose, at the right time, and by the right route (such as orally, intravenously, or topically). Failure to follow these guidelines can lead to ineffective treatment or even harm.

They all interact with other drugs and substances: Drugs can interact with each other, as well as with other substances such as food, alcohol, or tobacco. These interactions can affect drug absorption, metabolism, or elimination, and may increase or decrease the drug's effectiveness or toxicity.

Ella Rainwater does not know where Dr. Bronchi’s office is located. The clinic is out of brochures that have Dr. Bronchi’s address, contact number and directions. To help Ms. Rainwater, the medical assistant could:

Answers

To help Ms. Rainwater, the medical assistant could check the electronic records for the information about Dr. Bronchi’s address, contact number and directions.

Who is a Medical assistant?

This is referred to as a healthcare professional who specializes in assisting Doctors in a healthcare facility. They are also involved in the documentation processes and observations of the client or patient.

In this scenario, we were told that the clinic is out of brochures which contains information about the staffs and is usually in the form of a book or pamphlet.

Therefore, the best option for the medical assistant will be to check the electronic health records for the necessary information as it is easily accessible and a more reliable way of storing data.

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Fentanyl, the synthetic opioid sold illegally on
the street that is mixed with heroin or other
drugs, poses an extremely high risk of overdose
because
of its greater toxicity; an extremely small dose
can be lethal.
overdoses can occur more suddenly, narrowing
the window for intervention.
it may be undetectable when mixed with heroin
or pressed into pills.
O All of the above

Answers

Answer:

O All of the above

Explanation:

All of the statements mentioned are true regarding the high risk of overdose associated with fentanyl. Fentanyl, a synthetic opioid, is known to be highly potent and has a much higher toxicity compared to other opioids. This means that even a small dose of fentanyl can be lethal, leading to a high risk of overdose.

these chemicals are carcinogenic by-products of chlorine compound manufacture and incineration that are mainly distributed through the air.

Answers

Dioxins are the chemicals which are carcinogenic by-products of chlorine compound manufacture and incineration that are mainly distributed through the air. Thus, the correct option is A.

What are Dioxins?

Dioxins and dioxin-like compounds are a group of chemical compounds which are carcinogenic by-products of chlorine compounds manufacture that are the persistent organic pollutants in the environment. They are mostly generated as the by-products of burning or various industrial processes or, in other case of dioxin-like PCBs and PBBs, unwanted minor components of the intentionally produced mixtures.

Dioxins can easily enter the body through the air which we breathe or by the skin contact. Persons who burn household waste may come into contact with dioxins more as it is present in the ash, soil, gas, or smoke.

Therefore, the correct option is A.

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Your question is incomplete, most probably the complete question is:

These chemicals are carcinogenic by-products of chlorine compound manufacture and incineration that are mainly distributed through the air.

A: dioxins

B: pesticides

C: endocrine disrupters

D: polychlorinated biphenyls

What led to the development of behavioral models of couples therapy?

Answers

Answer:

i don't know

Explanation:

i don't know

What causes physical and emotional
changes during adolescence?
A. faster rate of learning expected in high school
B. peer pressure and social norms
C. high levels of hormones within the body

Answers

Answer: c

Explanation:

C.... higher hormones in the body
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