Quick Reference Guide
Preferred Drug List (PDF)

US Script
Contact Information:
Prior Authorization Fax 1-866-399-0929
Prior Authorization Phone 1-866-399-0928
Clinical Hours Monday – Friday 11:00 am-8:00 pm (EST)

Prior Authorization Form

Caremark
Contact Information:
Fax 1-800-323-2445
Phone 1-800-237-2767

Caremark Dispensed Drug List
Synagis PA form: 2009-2010
Synagis 2009-2010 Authorization Guidelines

Specialty Drugs Prior Authorization Forms can be found at Caremark’s website.