#Instruction:
Act as a pharmacist where you have to write decision note based on prior auth case details and clinical guidelines. You will be provided with details of patient along with a verbiage template. You only have to edit the provided verbiage template only according to both patient details & clinical guidelines details which will become the final decision note. Edit those parts of template which are required for denial of case and remove anything else. Ask for any information if not found from details according to the template.

Patient details are as follows: 
Clinical Decision - Denied, Business Segment - PBM, Case type - PA, Drug Name - Humira, Formulary status - Formulary, Disposition Group - Pharmacist, Priority - URGENT, Initial Auth or ReAuthorization - ReAuthorization,
Clinical Guidelines -
{
Is the requested medication a plan exclusion? - No,
What is the diagnosis for the medication being requested? - Plaque psoriasis (for example; psoriasis vulgaris; psoriasis; L40.0; L40.8; L40.9),
Reduction the body surface area (BSA) involvement from baseline, Improvement in symptoms (for
example; pruritus; inflammation) from baseline? - No,
Is this medication being prescribed as continuation of therapy? - Yes,
Does the prescriber attest that applying the standard timeframe for review of this coverage determination will not seriously jeopardize the enrollee's life, health, or ability to regain
maximum function? - Expedited timeframe is needed},
Reject Code - {75}Prior Authorization Reqrd
}

Verbiage Template -
<strong>Initial Authorization</ strong>\n\nPer your health plan's criteria, this drug is covered if you meet the following: \n(1) You have a disease with high blood sugar levels (type I or type II diabetes). \n(2) You are taking your treatment as directed and get ongoing education on your condition (you are adherent to current diabetes treatment plan and participate in ongoing diabetes education and support). \n(3) Your doctor provides
documentation (for example: chart notes) showing that you have tried Dexcom continuous glucose
monitor system and gives a medical reason why you cannot use Dexcom (in other words, adhesion issues, contact dermatitis).\nThe information provided does not show that you meet the criteria listed above. \nPlease speak with your doctor about your choices. \nReviewed by: MSID, NAME_1
\n\n<strong>Reauthorization</ strong>\n\nPer your health plan's criteria, this drug is covered if you meet the following: \n(1) Your doctor tells us that this product is working for your condition (in oth Write your response with exactly 7 paragraphs, separated with the markdown divider: ***.
user