Cyclophosphamide,Anti-emetics,inhalation solutionsB vs DGridYesLidocaine/Prilocainecream, calcitriol, andlevocarnitineBvsD fororalchemo, NF,and QLContinuationof therapyPerform aname search inAS400 to see ifthe memberhas a part "D"plan5 and6UHCMRPerform aname search inAS400 to see ifthe memberhas a part "B"planGoldenSixKExcludedfrom partB and partDCarrier code:MPDOVA, Accountcode begins with an"O", Plan includes"MAO", Preferredproduct schedule isblankClosethe GPIESRDNegativeAuthorizationSamples weregiven or thepatient pickedup a transitionalsupplyNoProspectivePaymentSystembundleTitration purposes,dose is notcommerciallyavailable, or dosealternatingscheduleBvsDFertility agents,OTCs, Cosmeticagents,dietary/nutritionalsupplementsTriptans,OralFentanylproducts,OpioidsCialis 2.5mgand 5mg witha diagnosisof BPHCyclophosphamide,Anti-emetics,inhalation solutionsB vs DGridYesLidocaine/Prilocainecream, calcitriol, andlevocarnitineBvsD fororalchemo, NF,and QLContinuationof therapyPerform aname search inAS400 to see ifthe memberhas a part "D"plan5 and6UHCMRPerform aname search inAS400 to see ifthe memberhas a part "B"planGoldenSixKExcludedfrom partB and partDCarrier code:MPDOVA, Accountcode begins with an"O", Plan includes"MAO", Preferredproduct schedule isblankClosethe GPIESRDNegativeAuthorizationSamples weregiven or thepatient pickedup a transitionalsupplyNoProspectivePaymentSystembundleTitration purposes,dose is notcommerciallyavailable, or dosealternatingscheduleBvsDFertility agents,OTCs, Cosmeticagents,dietary/nutritionalsupplementsTriptans,OralFentanylproducts,OpioidsCialis 2.5mgand 5mg witha diagnosisof BPH

Golden Six/QL/BvsD/MA-Only/Exclusions/ESRD - Call List

(Print) Use this randomly generated list as your call list when playing the game. There is no need to say the BINGO column name. Place some kind of mark (like an X, a checkmark, a dot, tally mark, etc) on each cell as you announce it, to keep track. You can also cut out each item, place them in a bag and pull words from the bag.


1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
  1. Cyclophosphamide, Anti-emetics, inhalation solutions
  2. B vs D Grid
  3. Yes
  4. Lidocaine/Prilocaine cream, calcitriol, and levocarnitine
  5. BvsD for oral chemo, NF, and QL
  6. Continuation of therapy
  7. Perform a name search in AS400 to see if the member has a part "D" plan
  8. 5 and 6
  9. UHCMR
  10. Perform a name search in AS400 to see if the member has a part "B" plan
  11. Golden Six
  12. K
  13. Excluded from part B and part D
  14. Carrier code: MPDOVA, Account code begins with an "O", Plan includes "MAO", Preferred product schedule is blank
  15. Close the GPI
  16. ESRD Negative Authorization
  17. Samples were given or the patient picked up a transitional supply
  18. No
  19. Prospective Payment System bundle
  20. Titration purposes, dose is not commercially available, or dose alternating schedule
  21. BvsD
  22. Fertility agents, OTCs, Cosmetic agents, dietary/nutritional supplements
  23. Triptans, Oral Fentanyl products, Opioids
  24. Cialis 2.5mg and 5mg with a diagnosis of BPH