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When a PBM contract transition happens (as with the CalPERS example above), a patient's previously preferred pharmacy can change without either the prescriber or patient initiating anything worth a quick verification at the next visit for patients on maintenance medications, rather than assuming last year's pharmacy routing still applies

It can appear as a reddish-pink or brownish-black lesion, predominantly distributed on the face, neck, or lower extremities while acral location is rare