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Before you get started, in addition to your insurance card, you will need the following information. This information can be obtained by contacting your prescribing physician.

For Prescription Drugs:

  • Name of drug/medication
  • Strength of the drug (example 5 mg)
  • Quantity being prescribed
  • Days supply

For Medical Services:

  • Description of service
  • Start date of service
  • End date of service
  • Service code if available (HCPCS/CPT)
  • New Prior Authorization
  • Check Status
  • Complete Existing Request
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