Does aetna cover semaglutide - Aetna's conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna). Your benefits plan determines coverage. Some plans exclude coverage for services or supplies that Aetna considers medically necessary.

 
Getting Wegovy covered by insurance starts with a visit to your healthcare provider, who will determine whether you qualify for Wegovy. If you do, they’ll write you a prescription. You can either have your healthcare provider send the prescription to the pharmacy or rake it there yourself, where your pharmacist can check your coverage.. Lycomap

Semaglutide ( Rybelsus and Ozempic) is used with diet and exercise to improve blood sugar control in adults with type 2 diabetes mellitus (not for type 1 diabetes). ... Shop for your own coverage Medical Dental Other Supplemental Plans through your employer. Learn about the medical, dental, pharmacy, behavioral, and voluntary benefits your ... My understanding is if you’ve got a higher BMI with abnormal blood work (the high LDL), you qualify for metabolic syndrome diagnosis, which can help with getting coverage. I’m sure experiences can vary depending on carrier and employer. 1. Reply. Long_Profession_2618. • 2 yr. ago. In early June, the U.S. Food and Drug Administration approved semaglutide 2.4 mg (Wegovy) for chronic management of obesity and for those with a body mass index (BMI)* of 27 or greater in the presence of at least one weight-related comorbid condition (e.g., hypertension, type 2 diabetes, or dyslipidemia). 1 Semaglutide is a member of the …Jul 24, 2023 · Ozempic (semaglutide), a prescription medication administered through injections, is FDA approved to help people with Type 2 diabetes manage their blood glucose (sugar) levels. Most health insurance providers cover the medication when it’s being used to treat Type 2 diabetes. The plans may now cover Wegovy when prescribed to prevent heart attacks and strokes, according to a new policy issued this week from the Centers for Medicare and Medicaid Services. Wegovy is a GLP ... Pharmacy Clinical Policy Bulletins are developed by Aetna to assist in administering plan benefits and constitute neither offers of coverage nor medical advice. This Clinical Policy Bulletin contains only a partial, general description of plan or program benefits and does not constitute a contract. AETNA BETTER HEALTH® Coverage Policy/Guideline Name: Ozempic and Trulicity Effective Date: 1/3/2024 . Last Review Date: 11/2023 . Applies to: ☐Illinois ... If the …Official answer. by Drugs.com. Yes, some insurance companies may cover your prescription for Mounjaro, but this will vary based on your insurance plan and drug benefits. The manufacturer of Mounjaro offers a savings card that can lower your cost to $25 for up to a 3-month supply, if you have commercial prescription insurance.Wegovy is a brand-name Semaglutide. Semaglutide has been approved for coverage by Medicare when medically necessary for diabetes through brands like Ozempic and now cardiovascular events through Wegovy. However, when Wegovy is prescribed specifically for weight loss, Medicare will not provide coverage. Therefore, Medicare …Find a list of covered prescription drugs under your Aetna plan - or for the plan you're considering if not yet a member - as well as medication cost estimates. All criteria below must be met in order to obtain coverage of Ozempic (semaglutide). To determine formulary coverage applicable to the specific benefit plan please refer to the formulary specific Aetna Pharmacy Drug Guide. Among the top 10 dental insurance plans ranked by Consumers Advocate, as of 2015, are plans from Delta Dental, Guardian Dental, United Concordia Dental, Ameritas and Cigna Dental. ... On the other hand, Sister in law Eight looks gentle and kind, but her mind is a little small. About old ladies, I think Sister in law Jiu would not tell does aetna cover semaglutide Weight Loss Pills Plenity Brother Jiu. Brother Jiu echoed with a smile Indeed, I really have not heard of this.The fourth elder brother looked up at the two unlucky ... According to GoodRx, 94% of Medicare Advantage plans and Medicare Part D plans covered Ozempic in 2023. 1. Medicare Advantage plans or Part D plans that cover Ozempic include copay amounts that can range widely from one plan to another. Plan members may also be responsible for meeting a deductible before the plan’s drug …A one-month supply of Ozempic (2 milligrams, the highest dosage) currently retails for $935.77 on the Novo Nordisk website, and prices range between approximately $900 and $1,100 on GoodRx. Novo ...The average employee doesn't know the extent of his workplace benefits and insurance plan—including whether your boss covers medical leave. By clicking "TRY IT", I agree to receive...This comprehensive guide aims to explore the multifaceted aspects of semaglutide’s impact on blood pressure, delving into its mechanisms of action, clinical study findings, patient experiences, and practical considerations for its use in treatment regimens. By examining how semaglutide may influence blood pressure, both directly …Carmel Wroth. Enlarge this image. Wegovy, a semaglutide medication, will be covered by Medicare. George Frey/Bloomberg via Getty Images. For the first time, …There's been such an increase in demand that an FDA database lists the medication's active ingredient, semaglutide, as "currently in shortage."Its manufacturer, Novo Nordisk, says keeping supplies ...Wegovy is a brand-name medication approved by the Food and Drug Administration (FDA) for weight loss in certain patients, including children 12 and older. It should be used together with a reduced-calorie diet and increased physical activity. Depending on your specific insurance plan, Blue Cross Blue Shield (BCBS) may cover …Summary. Retail Prescriptions (up to 30-day supply) - Generic drug: $15; Preferred brand-name drug: $40, plus the cost difference between the brand and the generic, if one exists.; Non-preferred brand-name drug: $80, plus the cost difference between the brand and the generic, if one exists. Retail Maintainence at CVS Pharmacy and Mail Order ...Wegovy (semaglutide) is used to help people lose weight and maintain weight loss. Wegovy is a GLP-1 Agnonist, which works by increasing insulin release and reducing appetite. It is used with a reduced calorie diet and exercise. Wegovy is available as cartons of four prefilled pens. There is currently no generic alternative to Wegovy.Policy/Guideline: If the patient has filled at least 60 days of metformin within the past 180 days under the Aetna Better Health prescription benefit and has a diagnosis of Type 2 Diabetes, then the requested drug will be paid under that prescription benefit. If the patient does not meet the. AETNA BETTER HEALTH®.Semaglutide was awarded the national contract 11/2/20 as the workhorse weekly GLP1A for new starts restricted to CFU. There is no requirement for switching patients. Decisions to do so can be made on an individual basis with provider and/or P&T input. SEMAGLUTIDE INJ,SOLN (Local Prior Authorization Required) is an item listed …Covering scars with makeup can help make them disappear. See five secrets to covering scars with makeup to learn the tricks of the trade. Advertisement Few of us are blessed with ...Aetna is a leading provider of Medicare Advantage plans, and they understand the importance of making it easy for their members to pay their premiums. AetnaMedicare.com offers seve...If you have private or commercial insurance, such as insurance you receive through an employer, you may be eligible to pay as little as $25 for a 1, 2, or 3 month prescription (maximum savings of $150 $ per one month prescription). , $300 per 2-month prescription or $450 per 3-month prescription).As of an October 2022 report from the Institute for Clinical and Economic Review, a month's supply of Wegovy (semaglutide) ran $1,300. High costs leave patients asking, does insurance cover weight loss medication? Since drugs like tirzepatide and semaglutide are meant to be taken indefinitely, starting one is a financial commitment.In today’s fast-paced world, staying fit and maintaining good health has become more important than ever. To encourage individuals to prioritize their well-being, Aetna has introdu...Wegovy ® contains semaglutide and should not be used with other semaglutide-containing products or other GLP-1 receptor agonist medicines. It is not known if …Semaglutide was awarded the national contract 11/2/20 as the workhorse weekly GLP1A for new starts restricted to CFU. There is no requirement for switching patients. Decisions to do so can be made on an individual basis with provider and/or P&T input. SEMAGLUTIDE INJ,SOLN (Local Prior Authorization Required) is an item listed …Aetna Trickery to Avoid Coverage of Wegovy. Insurance. I was so excited to see that Aetna was going to include Wegovy as a preferred brand (tier 2), such that with savings card …The fax cover sheet is faxed to the person who’s getting your facsimile document before the actual document is faxed. While a fax cover sheet is optional, the information on the co... On Aetna value plan. Wegovy is covered, starting in 2022, with a PA. You can use the discount card, comes out to $24.99/month for me (I’m on 1.7mg). Didn’t have to call Aetna to ensure it would be that cost, it just is. 1. Pay as little as $25 for Ozempic® (semaglutide) injection 0.5 mg, 1 mg, or 2 mg. Get started. Max savings of $150 for a 1-month, $300 for a 2-month, and $450 for a 3-month supply. Month defined as 28 days, offer good for up to 24 months. For eligible, commercially insured patients whose insurance covers Ozempic®.The cost of Ozempic (semaglutide) with Medicare varies depending on your specific Medicare plan and coverage. This can range from a modest copayment, such as $10 to $50 per prescription, or a percentage of the medication cost, such as 20% coinsurance. Medicare Part B.Please check directly with the health plan to confirm coverage for individual patients. b Offer available only to commercially insured patients with RYBELSUS ® coverage. Month is defined as 30 days. Maximum savings of $300 per 1-month supply, $600 per 2-month supply, or $900 per 3-month supply. I would say call Aetna directly then get a list of what they cover or if they cover anything for weight loss at all in your plan. It depends on your Caremark plan. Mine only covered ozempic with a PA in 2022 but starting 2023 you won’t need a PA. My Caremark plan covers it without restrictions. Official answer. by Drugs.com. Most prescription plans cover some or all of the cost for Ozempic when used to treat type 2 diabetes, but it’s not frequently covered for weight loss. The cost for Ozempic typically runs between $0 and $1029 per month. Your final cost will depend on your insurance plan benefits and any deductibles, co-insurance ... 3. If request is for a dose increase, new dose does not exceed one of the following: a. Trulicity: i. If request is for dose increase from 1.5 mg, new dose does not exceed 3 mg per week (4 vials or pens per month); ii. If request is for dose increase from 3 mg, new dose does not exceed 4.5 mg per week (4 vials or pens per month); Millions of Americans have burst pipes. Here's how insurance covers frozen pipes, and how to recoup your losses. By clicking "TRY IT", I agree to receive newsletters and promotions...Tesofensine is a medication that was developed to treat obesity by increasing the likelihood of weight loss. It is a small molecule compound that works as a “triple reuptake inhibitor.”. This means it works by blocking the body’s absorption of the three main neurotransmitters associated with “reward.”.Official answer. by Drugs.com. Most prescription plans cover some or all of the cost for Ozempic when used to treat type 2 diabetes, but it’s not frequently covered for weight loss. The cost for Ozempic typically runs between $0 and $1029 per month. Your final cost will depend on your insurance plan benefits and any deductibles, co-insurance ...Then, about 5 months ago, Bronder ran across some research about a weight loss drug called semaglutide (Wegovy). The drug mimics a naturally occurring hormone called GLP-1 that lessens cravings ...Tesofensine is a medication that was developed to treat obesity by increasing the likelihood of weight loss. It is a small molecule compound that works as a “triple reuptake inhibitor.”. This means it works by blocking the body’s absorption of the three main neurotransmitters associated with “reward.”.Wegovy is a prescription medication that is FDA-approved for chronic weight management in adults with obesity or overweight. It contains semaglutide, a hormone that helps regulate appetite and food intake. Wegovy is administered once a week via subcutaneous injection and is used in conjunction with a reduced-calorie diet and increased physical ...If you’re new to the world of stamp collecting, you may have come across the term “first day cover” or FDC. These are envelopes that bear a postage stamp which is cancelled on the ...According to GoodRx, 94% of Medicare Advantage plans and Medicare Part D plans covered Ozempic in 2023. 1. Medicare Advantage plans or Part D plans that cover Ozempic include copay amounts that can range widely from one plan to another. Plan members may also be responsible for meeting a deductible before the plan’s drug …Wegovy Costs and Copayments. Wegovy is administered through a weekly injection and the typical expense for a four-week supply ranges from $1,500 to $1,800, depending on where you obtain your prescription. On an annual basis, this works out to costs ranging from $18,000 to $21,600 per year. Health insurance can, of course, help with these costs.Semaglutide was awarded the national contract 11/2/20 as the workhorse weekly GLP1A for new starts restricted to CFU. There is no requirement for switching patients. Decisions to do so can be made on an individual basis with provider and/or P&T input. SEMAGLUTIDE INJ,SOLN (Local Prior Authorization Required) is an item listed …Wegovy (semaglutide), a prescription medication for chronic weight management, has a list price of about $1,350 for a 28-day supply. This means that the medication could cost more than $16,000 per year without insurance or manufacturer discounts. Coverage for weight-loss medications like Wegovy varies widely depending …Apr 12, 2024 · Wegovy (semaglutide), a prescription medication for chronic weight management, has a list price of about $1,350 for a 28-day supply. This means that the medication could cost more than $16,000 per year without insurance or manufacturer discounts. Coverage for weight-loss medications like Wegovy varies widely depending on the kind of insurance ... The precertification and quantity limits drug coverage review programs are not available in all service areas. However, these programs are available to self-insured plans. Health benefits and health insurance plans contain exclusions and limitations. Find out if your prescription drug is covered by your 2024 Aetna Standard Plan. Wegovy (semaglutide) is used to help people lose weight and maintain weight loss. Wegovy is a GLP-1 Agnonist, which works by increasing insulin release and reducing appetite. It is used with a reduced calorie diet and exercise. Wegovy is available as cartons of four prefilled pens. There is currently no generic alternative to Wegovy.As of an October 2022 report from the Institute for Clinical and Economic Review, a month's supply of Wegovy (semaglutide) ran $1,300. High costs leave patients asking, does insurance cover weight loss medication? Since drugs like tirzepatide and semaglutide are meant to be taken indefinitely, starting one is a financial commitment. Pharmacy Clinical Policy Bulletins are developed by Aetna to assist in administering plan benefits and constitute neither offers of coverage nor medical advice. This Clinical Policy Bulletin contains only a partial, general description of plan or program benefits and does not constitute a contract. On the other hand, Sister in law Eight looks gentle and kind, but her mind is a little small. About old ladies, I think Sister in law Jiu would not tell does aetna cover semaglutide Weight Loss Pills Plenity Brother Jiu. Brother Jiu echoed with a smile Indeed, I really have not heard of this.The fourth elder brother looked up at the two unlucky ...Semaglutide is a medication that can help manage blood sugar levels in people with type 2 diabetes. The coverage of Semaglutide under HSA varies depending on your specific plan. It is important to review your HSA plan documents or contact your HSA provider to determine if Semaglutide is covered. Semaglutide offers several benefits for diabetes ... In Maryland, by Aetna Health Inc., 151 Farmington Avenue, Hartford, CT 06156. Each insurer has sole financial responsibility for its own products. Pharmacy benefits are administered by an affiliated pharmacy benefit manager, CVS Caremark. Aetna is part of the CVS Health family of companies. 997050-01-07 (10/23) - - Apr 11, 2024 · Most prescription plans cover some or all of the cost for Ozempic when used to treat type 2 diabetes, but it’s not frequently covered for weight loss. The cost for Ozempic typically runs between $0 and $1029 per month. Your final cost will depend on your insurance plan benefits and any deductibles, co-insurance or copays you may have. Oct 23, 2023 · These plans often include prescription drug coverage. Plan availability and benefits can vary by location. You can speak with a licensed insurance agent to find Aetna Medicare Advantage plans in your area that cover prescription drugs by calling 1-800-891-6309, TTY: 711. They’re available 24 hours a day, 7 days a week. Dr. Russo and Dr. Shah expect a newly FDA-approved tirzepatide weight loss medication, Zepbound, to be covered in about a year. (It often takes a few months to a year before insurance companies ...Whether you want to preserve your home movies in hard copy or you’re producing some amazing training DVDs for your office, printing out covers can make the end result look polished...Ozempic ® (semaglutide) injection 0.5 mg, 1 mg, or 2 mg is an injectable prescription medicine used: along with diet and exercise to improve blood sugar (glucose) in adults with type 2 diabetes mellitus. to reduce the risk of major cardiovascular events such as heart attack, stroke, or death in adults with type 2 diabetes mellitus with known ...COVERAGE CRITERIA The requested drug will be covered with prior authorization when the following criteria are met: ... Wegovy (semaglutide) 0.25 mg/0.5 mL 2 mL (1 package of 4 pens each) / 21 days* 6 mL (3 packages of 4 pens each) / 63 days* 0.5 mg/0.5 mL 1 …AetnaSummary. Ozempic and other GLP-1 medications are effective weight loss medications that may or may not be covered by Medicare Part D. Because current legislation does not allow Medicare Part D to cover weight loss medications, these drugs will only be covered when they are used to treat diabetes. That could change as …Wegovy is a brand-name Semaglutide. Semaglutide has been approved for coverage by Medicare when medically necessary for diabetes through brands like Ozempic and now cardiovascular events through Wegovy. However, when Wegovy is prescribed specifically for weight loss, Medicare will not provide coverage. Therefore, Medicare …In Maryland, by Aetna Health Inc., 151 Farmington Avenue, Hartford, CT 06156. Each insurer has sole financial responsibility for its own products. Pharmacy benefits are administered by an affiliated pharmacy benefit manager, CVS Caremark. Aetna is part of the CVS Health family of companies. 997050-01-07 (10/23) - -If you have private or commercial insurance, such as insurance you receive through an employer, you may be eligible to pay as little as $25 for a 1, 2, or 3 month prescription (maximum savings of $150 $ per one month prescription). , $300 per 2-month prescription or $450 per 3-month prescription).Most prescription plans cover some or all of the cost for Ozempic when used to treat type 2 diabetes, but it’s not frequently covered for weight loss. The cost for Ozempic typically runs between $0 and $1029 per month. Your final cost will depend on your insurance plan benefits and any deductibles, co-insurance or copays you may have.Wegovy Costs and Copayments. Wegovy is administered through a weekly injection and the typical expense for a four-week supply ranges from $1,500 to $1,800, depending on where you obtain your prescription. On an annual basis, this works out to costs ranging from $18,000 to $21,600 per year. Health insurance can, of course, help with these costs.Pharmacy Clinical Policy Bulletins are developed by Aetna to assist in administering plan benefits and constitute neither offers of coverage nor medical advice. This Clinical Policy Bulletin contains only a partial, general description of plan or program benefits and does not constitute a contract.For example, the most populous U.S. state, California, provides some coverage to new weight-loss injections through its Medicaid program, but many others, including Texas, the No. 2 state in terms of population, do not, according to an online tool that Novo Nordisk created to help people check on coverage. Medicare does cover …Semaglutide is injected once weekly. Semaglutide is used for chronic weight management in addition to a reduced calorie diet and increased physical activity in adults, who have: a body mass index (BMIa) of 30 kg/m2 or greater (with obesity), or a BMIa of 27 kg/m2 and less than 30 kg/m2 (overweight) and weight-related health problems. Weight ...Aetna just approved my Wegovy! I’m curious how long they will actually cover it for. I know it takes a few months to get to the maintenance dose. I’ve heard it’s safe to take long-term but unclear if insurance will cover it long-term. Does anyone know?If Ozempic was a weight loss drug you would have a good shot, being a diabetes drug you may be denied unless you have a history of type 2 and have already tried metformin. It takes a few weeks. And your doctor may have to file more than one appeal. Last year, my first year, it took about a month. Wegovy Costs and Copayments. Wegovy is administered through a weekly injection and the typical expense for a four-week supply ranges from $1,500 to $1,800, depending on where you obtain your prescription. On an annual basis, this works out to costs ranging from $18,000 to $21,600 per year. Health insurance can, of course, help with these costs. Covering scars with makeup can help make them disappear. See five secrets to covering scars with makeup to learn the tricks of the trade. Advertisement Few of us are blessed with ...

We make coverage decisions on a case-by-case basis consistent with applicable policies. We review many of the services used by patients. These include tests, treatments, surgeries and hospital stays. We use nationally recognized guidelines to decide whether a service is appropriate and, therefore, covered. If we do not consider the service to .... Walmart employee discount hotels

does aetna cover semaglutide

We discuss if homeowners insurance covers water damage or not and what qualifying for water damage depends on. By clicking "TRY IT", I agree to receive newsletters and promotions f...Ozempic and other semaglutide medications have shown promise in women who are overweight or obese with PCOS, according to Dr. Sood, who explains that these medications improve metabolic parameters like weight loss and blood sugar levels. More studies looking at the effect of semaglutide GLP-1 receptor agonists on PCOS are …Pay as little as $25 for Ozempic® (semaglutide) injection 0.5 mg, 1 mg, or 2 mg. Get started. Max savings of $150 for a 1-month, $300 for a 2-month, and $450 for a 3-month supply. Month defined as 28 days, offer good for up to 24 months. For eligible, commercially insured patients whose insurance covers Ozempic®.Some potentially good news on that front came on November 21, as Aetna announced that it would begin covering weight management drugs in certain patients. This announcement does come with several important caveats, not least of which is that many Aetna plans specifically exclude any obesity medications, and so neither Qsymia nor Belviq would be ... 3. If request is for a dose increase, new dose does not exceed one of the following: a. Trulicity: i. If request is for dose increase from 1.5 mg, new dose does not exceed 3 mg per week (4 vials or pens per month); ii. If request is for dose increase from 3 mg, new dose does not exceed 4.5 mg per week (4 vials or pens per month); Pharmacy Clinical Policy Bulletins are developed by Aetna to assist in administering plan benefits and constitute neither offers of coverage nor medical advice. This Clinical Policy Bulletin contains only a partial, general description of plan or program benefits and does not constitute a contract.Wegovy (semaglutide), a prescription medication for chronic weight management, has a list price of about $1,350 for a 28-day supply. This means that the medication could cost more than $16,000 per year without insurance or manufacturer discounts. Coverage for weight-loss medications like Wegovy varies widely depending on the kind of insurance ...Semaglutide is a medication that belongs to a class of drugs called GLP-1 receptor agonists. It is used to treat type 2 diabetes and works by stimulating the release of insulin and reducing the production of glucose in the liver. Semaglutide is administered as a once-weekly injection and has been shown to effectively lower blood sugar levels ...Our analysis also found a lack of transparency about how health plans cover semaglutide, as 7 of the 18 included plans did not issue a public coverage policy for the drug. Non-issuance of a coverage policy does not necessarily mean non-coverage, though it does mean that coverage information is not publically available.Wegovy is a prescription medication that is FDA-approved for chronic weight management in adults with obesity or overweight. It contains semaglutide, a hormone that helps regulate appetite and food intake. Wegovy is administered once a week via subcutaneous injection and is used in conjunction with a reduced-calorie diet and increased physical ...Aetna sells three different SilverScript plans, and the Aetna Medicare drug formulary may vary slightly from one plan to another. Below are the SilverScript plan formularies for 2024. 2024 SilverScript Choice Part D plan formulary ( Spanish ) 2024 SilverScript Plus plan formulary ( Spanish) 2024 SilverScript SmartSaver plan formulary …A fax cover sheet should list who the fax is from, who the recipient is and the number of pages in the fax. The number of pages should include the cover sheet.Are you a recipient of Aetna Medicaid? If so, you may be wondering how to find healthcare providers and specialists within the Aetna Medicaid network. Aetna Medicaid is a managed c...The phase III study showed that semaglutide significantly reduced the composite of cardiovascular death, heart attack, and stroke by 20% (HR 0.80, 95% CI 0.72-0.90).What to do if your drugs are changing. Talk to your doctor to find out if changing to a preferred drug is right for you. If they agree, have them send a new prescription to your pharmacy so it’s ready for you to fill January 1, 2024. Your doctor may decide it’s best for you to stay on your current drug. If so, they can ask for medical ...Jan 1, 2023 · Aetna's conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna). Your benefits plan determines coverage. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Expedited medical exceptions. In certain circumstances*, you or your prescriber can request a medical exception for a non-covered drug. To submit a request, call our Precertification Department at 1-855-582-2025 (TTY: 711), or fax a request to 1-855-330-1716.You also can mail a written request to Aetna PA, 1300 E. Campbell Rd., …We make coverage decisions on a case-by-case basis consistent with applicable policies. We review many of the services used by patients. These include tests, treatments, surgeries and hospital stays. We use nationally recognized guidelines to decide whether a service is appropriate and, therefore, covered. If we do not consider the service to ...Pharmacy Clinical Policy Bulletins are developed by Aetna to assist in administering plan benefits and constitute neither offers of coverage nor medical advice. This Clinical Policy Bulletin contains only a partial, general description of plan or program benefits and does not constitute a contract.Are you on the hunt for a new job? One of the most important aspects of your job application is your cover letter. A well-written cover letter can help you stand out from the compe....

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