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Medicare Part D Pharmacy Prior Authorization and Determination Forms
If you need additional information regarding Medicare Part D prior
authorization and determination forms call
1-800-311-0354. You
may also fax the forms to 1-800-373-0238 or e-mail to Medicare_PA@pharmacare.com
Click on a link below to see the full list of forms available.
Medications That Require Prior Authorization
Determination and Redetermination Forms
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