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 web page.