Prior Authorization Forms
Documents
Amevive
| Date added: | 02/04/2010 |
| Filesize: | 92.57 kB |
| Downloads: | 155 |
Aranesp
| Date added: | 03/17/2010 |
| Filesize: | 25.35 kB |
| Downloads: | 166 |
Boniva
| Date added: | 07/13/2010 |
| Filesize: | 27.21 kB |
| Downloads: | 175 |
Byetta
| Date added: | 07/13/2010 |
| Filesize: | 68.84 kB |
| Downloads: | 172 |
Cimzia
| Date added: | 07/13/2010 |
| Filesize: | 20.78 kB |
| Downloads: | 142 |
Enbrel
| Date added: | 07/13/2010 |
| Filesize: | 25.09 kB |
| Downloads: | 156 |
Forteo
| Date added: | 02/04/2010 |
| Filesize: | 91.06 kB |
| Downloads: | 142 |
Growth Hormone
| Date added: | 02/04/2010 |
| Filesize: | 95.33 kB |
| Downloads: | 201 |
Humira
| Date added: | 07/13/2010 |
| Filesize: | 25.44 kB |
| Downloads: | 155 |
Kineret
| Date added: | 02/04/2010 |
| Filesize: | 90.83 kB |
| Downloads: | 162 |
Lupron
| Date added: | 07/13/2010 |
| Filesize: | 30.79 kB |
| Downloads: | 159 |
Multiple Sclerosis
| Date added: | 02/04/2010 |
| Filesize: | 95.06 kB |
| Downloads: | 175 |
Neupogen
| Date added: | 03/17/2010 |
| Filesize: | 29.94 kB |
| Downloads: | 137 |
Pegasys & Peg-Intron
| Date added: | 02/04/2010 |
| Filesize: | 23.46 kB |
| Downloads: | 233 |
Procrit & Epogen
| Date added: | 03/17/2010 |
| Filesize: | 25.35 kB |
| Downloads: | 161 |
Pulmonary Hypertension
| Date added: | 02/04/2010 |
| Filesize: | 62.07 kB |
| Downloads: | 148 |
Raptiva
| Date added: | 07/13/2010 |
| Filesize: | 24.6 kB |
| Downloads: | 147 |
Reclast
| Date added: | 07/06/2010 |
| Filesize: | 170.94 kB |
| Downloads: | 160 |
Remicade
| Date added: | 07/06/2010 |
| Filesize: | 167.1 kB |
| Downloads: | 144 |
Sensipar
| Date added: | 03/17/2010 |
| Filesize: | 31.7 kB |
| Downloads: | 128 |
Ohio Valley/Mountaineer Region
P: 1.800.624.6961, ext. 7914
TTY/TDD: 1.800.622.3925
Email: pharmacy@healthplan.org
Hours: Mon- Fri., 8:30 am to 5:00 pm
HomeTown Region
P: 1.800.624.6961, ext. 7914
TTY/TDD: 1.877.236.2291
Email: pharmacy@healthplan.org
Hours: Mon- Fri., 8:30 am to 5:00 pm
Pharmacy Newsflash!
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Product Recall - Pedicare As of May 28, 2010, Blacksmith Brands, Inc. in conjunction with the FDA, is voluntarily recalling all lots of four children’s products in the PediaCare line. These products were manufactured by...
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Important Recall Information McNeil Consumer Healthcare has voluntarily recalled all lots of certain children's and infant's liquid medications including certain over-the-counter Tylenol, Motrin, Zyrtec and Benadryl. This precautionary...
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Medtronic Diabetes Voluntary Recall Medtronic Diabetes is voluntarily recalling Quick-set infusion sets that have lot numbers starting with the number "8" ("Lot 8" Quick-set infusion sets). These infusion sets are used with MiniMed Paradigm...
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