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Content and Time Limits on Claims Submissions Proofs of Loss ; . If a charge is made to a Member for any service that is reimbursable under the Group Contract, written proof of such charge shall include an itemized statement and diagnosis and must be submitted to HealthAssurance at the address above within ninety 90 ; days after the delivery of the service or as soon as reasonably possible, but in no event, except in the absence of legal capacity, later than one year after the date of service. Such services must have been provided in accordance with HealthAssurance's utilization management and preauthorization policies and procedures. Failure to furnish such documentation within the specified period shall invalidate or reduce any such claim unless for good reason, as determined by HealthAssurance, it was not possible to submit the claim within the specified period, provided such proof is produced in a timely basis. Time of Payment of Claims. Upon receipt of a claim, HealthAssurance will promptly make payment to the person or institution providing the services, or at HealthAssurance's discretion may make payment directly to the Subscriber. However, if the Subscriber furnishes evidence satisfactory to HealthAssurance that payment has been made to such person or institution for the service covered, reimbursement will be made to the Subscriber after deducting any payment made by HealthAssurance before receipt of such evidence. HealthAssurance will reimburse up to the Out-of-Network Rate for services rendered. Legal Actions. No legal action for reimbursement of a claim for payment for services rendered by a Non-Participating Provider may be initiated prior to the expiration of sixty 60 ; days after written proof of the loss upon which claim is based has been provided to HealthAssurance. No legal action for reimbursement of a claim for payment for services rendered by a Non-Participating Provider may be initiated more than three 3 ; years after the expiration of the time within which proof of such loss is required and dextromethorphan.

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Anticholinergics and antihistamines, gastrointestinal antispasmodics, muscle relaxants, oxybutynin Ditropan ; , flavoxate Urispas ; , anticholinergics, antidepressants, decongestants, and tolterodine Detrol ; -Blockers Doxazosin, Prazosin, and Terazosin ; , anticholinergics, tricyclic antidepressants imipramine hydrochloride, doxepin hydrochloride, and amitriptyline hydrochloride ; , and long-acting benzodiazepines Tricyclic antidepressants imipramine hydrochloride, doxepin hydrochloride, and amitriptyline hydrochloride ; Decongestants, theophylline Theodur ; , methylphenidate Ritalin ; , MAOIs, and amphetamines Metoclopramide Reglan ; , conventional antipsychotics, and tacrine Cognex ; Barbiturates, anticholinergics, antispasmodics, and muscle relaxants. CNS stimulants: dextroAmphetamine Adderall ; , methylphenidate Ritalin ; , methamphetamine Desoxyn ; , and pemolin Long-term benzodiazepine use. Sympatholytic agents: methyldopa Aldomet ; , reserpine, and guanethidine Ismelin ; CNS stimulants: DextroAmphetamine Adderall ; , methylphenidate Ritalin ; , methamphetamine Desoxyn ; , pemolin, and fluoxetine Prozac ; Short- to intermediate-acting benzodiazepine and tricyclic antidepressants imipramine hydrochloride, doxepin hydrochloride, and amitriptyline hydrochloride ; SSRIs: fluoxetine Prozac ; , citalopram Celexa ; , fluvoxamine Luvox ; , paroxetine Paxil ; , and sertraline Zoloft ; Bupropion Wellbutrin ; Olanzapine Zyprexa ; Long-acting benzodiazepines: chlordiazepoxide Librium ; , chlordiazepoxide-amitriptyline Limbitrol ; , clidinium-chlordiazepoxide Librax ; , diazepam Valium ; , quazepam Doral ; , halazepam Paxipam ; , and chlorazepate Tranxene ; . -blockers: propranolol Calcium channel blockers, anticholinergics, and tricyclic antidepressant imipramine hydrochloride, doxepin hydrochloride, and amitriptyline hydrochloride and dicloxacillin.

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Did some digging myself and the only close matches are two different doses of dextrostat dextroamphetamine ; manufactured by shire. Supported by a grant from Merck. Dr. Bombardier has received clinical research support from Aventis Pharma, Merck Research Laboratories, and Merck Frosst Canada. She has served as a consultant to Knoll Pharmaceutical, Aventis Canada, Schering Canada, Merck Research Laboratories, and WyethAyerst. Dr. Laine has received clinical research support from Merck, Wyeth Ayerst, and AstraZeneca. He has served as a consultant to Merck, Searle, Johnson & Johnson, AstraZeneca, WyethAyerst, and Tap Pharmaceuticals. Dr. Burgos-Vargas has received clinical research support from Merck Sharp & Dohme, Pfizer, and Boehringer Ingelheim. He has served as a consultant to Merck and has been a member of a speakers' bureau sponsored by Merck Sharp & Dohme. Dr. Davis has served as a consultant to Mirvant, Merck Research Laboratories, Parke-Davis, and SmithKline Beecham. Dr. Day has received clinical research support from Merck, Searle, Pfizer, Roche, and Amgen. He has served as a consultant to Merck, Searle, and Pfizer. He has been a member of speakers' bureaus sponsored by Merck Sharp & Dohme, Searle, Pfizer, and SmithKline Beecham. Dr. Ferraz has received clinical research support from Bristol-Myers Squibb, Merck Sharp & Dohme, and Aventis Pharma. He has served as a consultant to Aventis Pharma. Dr. Hawkey has received clinical research support from AstraZeneca, Asta Medica, Boehringer Ingelheim, Boots Healthcare International, Cell Tech, Eisai, Elan, Merck Research Laboratories, NicOx, and Novartis. He has served as a consultant to AstraZeneca, Abbott, Cell Tech, Eisai, Merck Research Laboratories, NicOx, Novartis, Parke-Davis, and Synthelabo Pharmacie. He has been a member of speakers' bureaus sponsored by AstraZeneca, Boehringer Ingelheim, Boots Healthcare International, Takeda, Wyeth Lederle, and Merck Research Laboratories. Dr. Hochberg has received clinical research support from Merck and Quintiles Aventis Pharma ; . He has served as a consultant to Aventis Pharma, Biomatrix, Merck, Negma Laboratories, Procter & Gamble, Roche, and WyethAyerst. He owns stock in Johnson & Johnson, Eli Lilly, Merck, Procter & Gamble, and Schering-Plough. Dr. Kvien has received clinical research support from Merck, Searle, Aventis Pharma, and Schering-Plough. He has served as a consultant to Merck, Searle, Aventis Pharma, and Schering-Plough. He has been a member of a speakers' bureau sponsored by Merck and Aventis Pharma. Dr. Schnitzer has received clinical research support from Abbott, Boehringer Ingelheim, Johnson & Johnson, McNeil Consumer Products, Merck, Novartis, Ortho-McNeil, Parke-Davis, Searle, and WyethAyerst. He has served as a consultant to Boehringer Ingelheim, Merck, Novartis, Ortho-McNeil, Searle, and SmithKline Beecham. He has been a member of speakers' bureaus sponsored by Boehringer Ingelheim, Merck, OrthoMcNeil, WyethAyerst, and Searle. Dr. Weaver has received clinical research support from Merck, Searle, Immunex, WyethAyerst, Aventis Pharma, PharmaciaUpjohn, Eli Lilly, Connetics, Parke-Davis, Procter & Gamble, Pfizer, HoffmannLaRoche, Centocor, Amgen, Cyprus Bioscience, Helsinn, Novartis, and Boehringer Ingelheim. He has served as a consultant to Merck, Searle, Immunex, WyethAyerst, Aventis Pharma, PharmaciaUpjohn, Eli Lilly, Connetics, Parke-Davis, Procter & Gamble, Pfizer, HoffmannLaRoche, Centocor, Amgen, Cyprus Bioscience, Helsinn, Novartis, and Boehringer Ingelheim. He has been a member of speakers' bureaus sponsored by Merck, Searle, Immunex, WyethAyerst, Aventis Pharma, PharmaciaUpjohn, Eli Lilly, Connetics, Parke-Davis, Procter & Gamble, Pfizer, HoffmannLaRoche, Centocor, Amgen, Cyprus Bioscience, Helsinn, Novartis, and Boehringer Ingelheim. He is on the board of directors of MGI Pharma and diflunisal.

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