Pharmacy
Quick Reference Guide
Preferred Drug List – Updated January 2012
FDA Update (Q3 2011)
FDA Update (Q2 2011)
FDA Update (Q1 2011)
Drug Labeling Changes (Q1 2011)
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)
Retail Drug Prior Authorization Form
Specialty Medications
All prior authorization requests should be faxed to Absolute Total Care at 1-855-865-9469. For more information, call 1-866-433-6041.
Specialty Drug Prior Authorization Form (general form)
Specialty Drug Prior Authorization Forms (for specific drugs and/or therapeutic classes)
Synagis Letter
Synagis PA Form: 2011-2012
Synagis 2011-2012 Authorization Guidelines
Caremark
Contact Information:
Phone 1-800-237-2767
