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Mirena specialty pharmacy

Mirena specialty pharmacy 2025

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The document is a prescription request form for Bayer's Women's HealthCare products, specifically the intrauterine systems (IUS) Kyleena, Mirena, and Skyla. It includes sections for selecting specialty pharmacies, patient and prescriber information, prescription details, and patient authorization for sharing health information. The form outlines the process for ordering these contraceptive devices, provides important safety information regarding their use, and emphasizes the need for proper documentation and communication between patients, prescribers, and pharmacies.

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Click ‘Get Form’ to open the mirena specialty pharmacy request form in the editor.
Select your preferred Specialty Pharmacy from the options provided. Ensure you note their fax numbers and hours of operation for future reference.
Fill in the Patient Information section, including last name, first name, date of birth, address, and contact details. Make sure all fields are completed accurately.
In the Prescription Information section, indicate which product (Kyleena, Mirena, or Skyla) is being requested. Include the appropriate ICD-10 codes and any allergies.
Complete the Prescriber Information section with all necessary details about the prescriber. This includes their name, title, contact information, and DEA number if applicable.
Have the patient read and sign the Patient Authorization section before faxing the completed form to the selected Specialty Pharmacy.

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Can IUDs be bought at a pharmacy?

Your doctor or nurse practitioner will write you a script and you can get the IUD from a pharmacy. Sometimes you can buy a copper IUD from the clinic providing the IUD insertion. The IUD is inserted inside your uterus by a trained doctor or nurse.

What class of drug is the Mirena?

Mirena (levonorgestrel) Mirena is a brand-name hormone-releasing intrauterine device (IUD) thats prescribed as a form of birth control. Mirena contains the active drug levonorgestrel and belongs to the progestin drug class.

What category is the Mirena?

Mirena is brand name for a hormonal intrauterine device (IUD). A hormonal IUD is a type of birth control thats placed in the uterus and uses hormones to give long-term birth control. Birth control also is called contraception. The device is a T-shaped plastic frame.

What are considered specialty drugs?

Medications must be either identified as high cost, high complexity or high touch to be classified as a specialty medication by Magellan Rx Management. Specialty pharmaceuticals are defined as high-cost oral or injectable medications used to treat complex chronic conditions.

Do pharmacies stock IUDs?

Available at most pharmacies with a script, and inserted by a trained doctor or nurse. Copper IUDs: small, T-shaped contraceptive devices inserted into the uterus. They do not contain hormones, and constantly release a small amount of copper into the uterus.

Is Mirena a specialty drug?

Depending on a patients insurance plan, offices can order Mirena through a Specialty Pharmacy. Specialty Pharmacies may be able to bill the insurance company directly for Mirena.

Is Mirena covered by medical?

All Medicaid programs are required to cover family planning services without cost-sharing. State coverage decisions and patient out-of-pocket costs can vary. Most Medicaid patients have no out-of-pocket expense for the Mirena IUD.

How much is Mirena without insurance?

People without insurance will pay about $1,303 for just the Mirena device at its full retail price. Mirena provides birth control for up to seven years, and so the average annual cost works out to $186. Thats about $15 per month if the device remains in place for the full seven years.

Mirena specialty pharmacy 2025

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Complete this form in 5 minutes or less

Got questions?

Can IUDs be bought at a pharmacy?

What class of drug is the Mirena?

What category is the Mirena?

What are considered specialty drugs?

Do pharmacies stock IUDs?

People also ask

Is Mirena a specialty drug?

Is Mirena covered by medical?

How much is Mirena without insurance?

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Mirena specialty pharmacy 2025

Here's how it works

How to use or fill out mirena specialty pharmacy with our platform

Complete this form in 5 minutes or less

Got questions?

Can IUDs be bought at a pharmacy?

What class of drug is the Mirena?

What category is the Mirena?

What are considered specialty drugs?

Do pharmacies stock IUDs?

Related Searches

People also ask

Is Mirena a specialty drug?

Is Mirena covered by medical?

How much is Mirena without insurance?

Related links

Try more PDF tools