Pharmacy prior authorization

Request a pharmacy prior authorization

For phone requests or emergencies

  • Call the pharmacy authorization services line at 1-800-562-3022 ext. 15483.

For fax requests

For reimbursement requests at less than cost, not related to brand name dispense as written (DAW)

  • For phone requests
    • Call the pharmacy rates department at 1-800-562-3022 ext. 16135.

  • For fax requests

Note: For information on billing and rates, the Apple Health preferred drug list, and expedited authorization codes, please visit the Prescription Drug Program on our provider billing guide and rates page.