Pharmacy

For Pharmacy forms, please go to our Forms page.

  • J Code Prior Authorization Changes

    Please refer to the Code LookUp Tool to determine J Code prior authorization requirements effective July 1, 2022.

    See a list of prior authorization requirement changes effective May 1, 2021 

    See a list of prior authorization requirement changes effective October 1, 2020 

    These medications require prior authorization effective September 1, 2020

    Please refer to the prior authorization list for a complete list of medications and services that require prior authorization.