866-814-5506

Phone: 1-866-814-5506 Fax: 1-855-330-1720 www.caremark.com Page 1 of

To check to the status of a submitted PA, call 808-254-4414 or 1-866-814-5506, Monday through Friday, 8 a.m.-5 p.m. Hawaii Standard Time. Specialty ...P: 866 -433-6041 F: 855 -865-9469 Advicare P: 866 814 5506 F: 866 249 6155 BlueChoice HealthPlan Medicaid P: 866 -902 1689 F: 800-823-5520 FFS Medicaid P:866 247 1181 F:888 -603 7696 First Choice P: 866 610 2773 F: 866 610 2775 Molina Healthcare P: 855-237-6178 F: 855-571-3011 WellCare Health Plan P: 888-588-9842 F: 866-354-8709MemberName:{{MEMFIRST}}{{MEMLAST}}DOB:{{MEMBERDOB}}PANumber:{{PANUMBER}} Sendcompletedformto:CaseReviewUnit,CVSCaremarkPriorAuthorizationFax:1-866-249-6155

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Scam Numbers - Find out who called you. Scam-numbers.com is one of the most advanced reverse phone lookup tools in the United States. Supported by a network of thousands of users, and using the world's most advanced web technologies, Scam Numbers helps you identify potential scam, nuisance, phishing and fraud phone calls. In order to find out who …For requests for drugs on the Aetna Specialty Drug List, call at 1-866-814-5506 (TTY: 711) or fax your completed prior authorization request form (PDF) to 1-866-249-6155. For more information, call the Provider Help Line at 1-800-AETNA RX (1-800-238-6279) (TTY: 711) . *Availity is available only to U.S. providers and its territories. Legal noticesPhone: 1-866-814-5506 Fax: 1-866-249-6155 www.caremark.com Page 1 of 2 Berinert Prior Authorization Request CVS Caremark administers the prescription benefit plan for the patient identified. This patient’s benefit plan requires prior authorization for certain medications in order for the drug to be covered.Phone: 1-866-814-5506 Fax: 1-866-249-6155 www.caremark.com Page 1 of 4. Neulasta, Fulphila, Udenyca Prior Authorization Request . CVS Caremark administers the prescription benefit plan for the patient identified. This patient’s benefit plan requires prior authorization for certain medications in order for the drug to be covered.regarding the prior authorization, please contact CVS Caremark at 1-866-814-5506. For inquiries or questions related to the patient’s eligibility, drug copay or medication delivery; please contact the Specialty Customer Care Team: CaremarkConnect® 1-800-237-2767. The recipient of this fax may make a request to opt-out of receiving telemarketing fax …Phone: 1-808-254-4414 Fax: 1-866-237-5512 www.caremark.com Page 1 of 3 Hyaluronate Products HMSA - Prior Authorization Request CVS Caremark administers the prescription benefit plan for the patient identified. This patient’s benefit plan requires prior authorization for certain medications in order for the drug to be covered. To make an appropriate …41 searches. (866) 960-1091. (866) 951-9700. Did you get a call or text from 866-814-5506? View owner's full name, address, public records, and background check for +18668145506 with Whitepages reverse phone lookup. 41 searches. (866) 960-1091. (866) 951-9700. Did you get a call or text from 866-814-5506? View owner's full name, address, public records, and background check for +18668145506 with Whitepages reverse phone lookup. authorization, call 866-814-5506. 2 . Identifying PEBTF Members . PEBTF members’ ID cards appear as below. PEBTF members can be identified by the member prefix . OPB. Active Population . Retiree Population . 3 List of Specialty Drugs Excluded from PEBTF Medical Coverage Effective Jan. 1, 2019 . As mentioned above, CVS Specialty® …Phone: 1-866-814-5506 Fax: 1-866-249-6155 www.caremark.com Page 1 of 4. Neulasta, Fulphila, Udenyca Prior Authorization Request . CVS Caremark administers the prescription benefit plan for the patient identified. This patient’s benefit plan requires prior authorization for certain medications in order for the drug to be covered.Phone: 1-866-814-5506 Fax: 1-866-249-6155 www.caremark.com Page 1 of 4 Cosentyx Prior Authorization Request CVS Caremark administers the prescription benefit plan for the patient identified. This patient’s benefit plan requires prior authorization for certain medications in order for the drug to be covered. All Plans Phone: 866-814-5506 Fax: 866-249-6155 Non-Specialty Medications : MassHealth Phone: 877-433-7643 Fax: 866-255-7569 Commercial Phone: 800-294-5979 Fax: 888-836-0730 Exchange Phone: 855-582-2022 Fax: 855-245-2134 . Medical Specialty Medications (NLX) All Plans Phone: 844-345-2803 Fax: 844-851-0882 . Exceptions. Overview .Phone: 1-866-814-5506 Fax: 1-866-249-6155 www.caremark.com Page 1 of 3 Sandostatin, Bynfezia, Mycapssa (octreotide) Prior Authorization Request CVS Caremark administers the prescription benefit plan for the patient identified. This patient’s benefit plan requires prior authorization for4 Jan 2022 ... Specialty 1-866-814-5506. • Fax the completed request form to: Non-Specialty 1-888-836-0730 or. Specialty 1-866-249-6155. • Mail the ...1-866-814-5506. For inquiries or questions related to the patient’s eligibility, drug copay or medication delivery; please contact the Specialty Customer Care Team: CaremarkConnect ® 1-800-237-2767. The recipient of this fax may make a request to opt-out of receiving telemarketing fax transmissions from CVS Caremark. There are numerousPhone: 1-866-814-5506 Fax: 1-866-249-6155 www.caremark.com Page 2 of 3 7. Does the patient have a confirmed diagnosis of severe major depressive disorder (single or recurrent episode), documented by standardized rating scales that reliably measure depressive symptoms (e.g., Beck Depression Scale1-866-814-5506. For inquiries or questions related to the patient’s eligibility, drug copay or medication delivery; please contact the Specialty Customer Care Team: CaremarkConnect ® 1-800-237-2767. The recipient of this fax may make a request to opt-out of receiving telemarketing fax transmissions from CVS Caremark. There are numerousSpecialty Medication PA Request Phone: (866) 814-5506. Nonspecialty Medication PA Request Phone: (877) 433-7643 (Medicaid), (855) 582-2022 (Exchange),. (800) ...Phone: 1-866-814-5506 Fax: 1-866-249-6155 www.caremark.com Page 1 of 3 Tavalisse Prior Authorization Request CVS Caremark administers the prescription benefit plan for the patient identified. This patient’s benefit plan requires prior authorization for certain medications in order for the drug to be covered.• Phone 866-814-5506 • Fax 866-249-6155 Preventive Dental Care Delta Dental 800-872-0500 Pediatric Dental Delta Dental 855-264-7898 Sleep Study Authorizations CareCentrix 866-827-5861 Pediatric Vision EyeMed 844-201-3993 Paper Claims In-network HMO medical claims: Payer ID: 04293 Paper Claims: PO Box 853908, Richardson, TX 75085 …866-814-5506. PLAN DESIGN. Preferred brand-name medications are listed to help identify product that are clinically appropriate and cost-effective. Generics.Prior Authorization Form for Medical Procedures, Courses of Treatment, or Prescription Drug Benefits. If you have questions about our prior authorization requirements, please refer to CVS Caremark at 1-866-814-5506. All of the applicable information and documentation is required.Phone: 1-866-814-5506 Fax: 1-866-249-6155 www.caremark.com Page 1 of 2 Skyrizi Prior Authorization Request CVS Caremark administers the prescription benefit plan for the patient identified. This patient’s benefit plan requires prior authorization for certain medications in order for the drug to be covered.Medical Information Phone: 1-800-504-5434 Fax: 610-878-4550 Email: [email protected] (Standard business hours are 9:00 am - 5:00 pm ET)

Phone: 1-866-814-5506 Fax: 1-866-249-6155 www.caremark.com Page 1 of 4. Hepatitis C Prior Authorization Request . CVS Caremark administers the prescription benefit plan for the patient identified. This patient’s benefit plan requires prior authorization for certain medications in order for the drug to be covered.All Plans Phone: 866 -814-5506 Fax: 866 -249-6155 : ... 877-433-7643 Fax: 866-255-7569 Commercial Phone: 800-294-5979 Fax: 888-836-0730 Exchange Phone: 855-582-2022 Fax: 855-245-2134 : Medical Specialty Medications (NLX) All Plans Phone: 844 -345-2803 Fax: 844 -851-0882 : Exceptions: N/A: Overview : Prescriptions that meet the initial step …• Phone 866-814-5506 • Fax 866-249-6155 Preventive Dental Care Delta Dental 800-872-0500 Pediatric Dental Delta Dental 855-264-7898 Sleep Study Authorizations CareCentrix 866-827-5861 Pediatric Vision EyeMed 844-201-3993 Paper Claims In-network HMO medical claims: Payer ID: 04293 Paper Claims: PO Box 853908, Richardson, TX 75085-3908If you have questions regarding the prior authorization, please contact CVS Caremark at 1-866-814-5506. For inquiries or questions related to the patient's eligibility, drug copay or medication delivery; please contact the Specialty Customer Care Team: CaremarkConnect® 1-800-237-2767.All Plans Phone: 866-814-5506 Fax: 866-249-6155 . Non-Specialty Medications . MassHealth Phone: 877-433-7643 Fax: 866-255-7569 Commercial Phone: 800-294-5979 Fax: 888-836-0730 Exchange Phone: 855-582-2022 Fax: 855-245-2134 . Medical Specialty Medications (NLX) All Plans Phone: 844-345-2803 Fax: 844-851-0882 .

Check with the Social Security Administration. The SSA has a warning about these scams and suggests you contact them directly at 1-800-772-1213 to verify the reason for the contact and the person’s identity prior to providing any information to the caller. If you come across one of these scams, please report it to the Social Security ...Call the Pharmacy Precertification Unit: Non-Specialty 1-800-294-5979 (TTY: 711) or Specialty 1-866-814-5506 (TTY: 711). Fax the completed request form to: Non-Specialty 1-888-836-0730 or Specialty 1-866-249-6155 .…

Reader Q&A - also see RECOMMENDED ARTICLES & FAQs. All Plans Phone: 866-814-5506 Fax: 866-249-61. Possible cause: All Plans Phone: 866-814-5506 Fax: 866-249-6155 . Non-Specialty Medicatio.

Phone: 1-866-814-5506 Fax: 1-866-249-6155 www.caremark.com Page 1 of NUMPAGES 3 Otezla Prior Authorization Request CVS Caremark administers the prescription benefit plan for the patient identified. This patient’s benefit plan requires prior authorization for certain medications in order for the drug to be covered. Specialty drugs are used to treat chronic complex conditions and require special handling and close monitoring and must be obtained from CVS Specialty Pharmacy. Note: Preauthorization is required. Call CVS Specialty Pharmacy at 1-866-814-5506 (TTY:711). Pharmacy Tier IV ( Specialty generic drugs) Tier V (Specialty preferred brand drugs)For Prior Authorizations: Specialty 866-814-5506 / Non-Specialty 800-294-5979 Submit Claims: Caremark Claims Dept. P.O. Box 52136 Phoenix, AZ 85072-2136 Caremark.com. Behavioral Health and Chemical Dependency Claims: HMC Health Works Providers Call: 855-487-8914 Submit Claims: P.O. Box 981605, El Paso, TX 7999-1605 EDI Partner: Emdeon EDI Payer ...

1-866-814-5506 . or go to our . Forms for Health Care Professionals . page and scroll down to the Specialty Pharmacy Precertification (Commercial) drop-down menu. If the specific form you need is not there, scroll to the end of the list and use the generic Specialty Medication Precertification request form. Once you fill out the relevant form ...All Plans Phone: 866-814-5506 Fax: 866-249-6155 . ... 866-255-7569 Commercial Phone: 800-294-5979 Fax: 888-836-0730 Exchange Phone: 855-582-2022 Fax: 855-245-2134 . Medical Specialty Medications (NLX) All Plans Phone: 844-345-2803 Fax: 844-851-0882 . Exceptions. N/A . Overview . Saphnelo (anifrolumab) is a type 1 interferon (IFN) receptor …Phone: 1-866-814-5506 Fax: 1-866-249-6155 www.caremark.com Page 1 of 3 Palynziq Prior Authorization Request CVS Caremark administers the prescription benefit plan for the patient identified. This patient’s benefit plan requires prior authorization for certain medications in order for the drug to be covered.

To check to the status of a submitted PA, call 808-254-4414 or 1-866 Phone: 1-866-814-5506 Fax: 1-866-249-6155 www.caremark.com Page 1 of 3 Sandostatin, Bynfezia, Mycapssa (octreotide) Prior Authorization Request CVS Caremark administers the prescription benefit plan for the patient identified. This patient’s benefit plan requires prior authorization forIf you have questions regarding the prior authorization, please contact CVS Caremark at 1-866-814-5506. For inquiries or questions related to the patient's eligibility, drug copay or medication delivery; please contact the Specialty Customer Care Team: CaremarkConnect® 1-800-237-2767. Phone: 1-866-814-5506 Fax: 1-866-249-6155 www.caremaChat with your CareTeam from 8 AM to 9 PM ET to ask quest All Plans Phone: 866-814-5506 Fax: 866-249-6155 Non-Specialty Medications : MassHealth Phone: 877-433-7643 Fax: 866-255-7569 Commercial Phone: 800-294-5979 Fax: 888-836-0730 Exchange Phone: 855-582-2022 Fax: 855-245-2134 . … All Plans Phone: 866-814-5506 Fax: 866-249- MemberName:{{MEMFIRST}}{{MEMLAST}}DOB:{{MEMBERDOB}}PANumber:{{PANUMBER}} Sendcompletedformto:CaseReviewUnit,CVSCaremarkPriorAuthorization.Fax:1-866-249-6155 Phone: 1-866-814-5506 Fax: 1-866-249-6155 www.caremark.com Page 1 of 2 Xenazine (tetrabenazine) Prior Authorization Request CVS Caremark administers the prescription benefit plan for the patient identified. This patient’s benefit plan requires prior authorization for certain medications in order for the drug to be covered. Alimta® (For Maryland Only) Alphanate®, Humate-P®, Koate-DAll Plans Phone: 866-814-5506 Fax: 866-249-6155 . NonSpecialty Medication PA Request Phone: (866) 814-5506 • Phone 866-814-5506 • Fax 866-249-6155 Preventive Dental Care Delta Dental 800-872-0500 Pediatric Dental Delta Dental 855-264-7898 Sleep Study Authorizations CareCentrix 866-827-5861 Pediatric Vision EyeMed 844-201-3993 Paper Claims In-network HMO medical claims: Payer ID: 04293 Paper Claims: PO Box 853908, Richardson, TX 75085-3908 at 866-814-5506. I received a notification fr MemberName:{{MEMFIRST}}{{MEMLAST}}DOB:{{MEMBERDOB}}PANumber:{{PANUMBER}} Sendcompletedformto:CaseReviewUnit,CVSCaremarkPriorAuthorization.Fax:1-866-249-6155CVS Caremark is dedicated to helping physicians manage and help their patients who are suffering from complex disorders and require specialized therapies and personalized care. Phone: 1-866-814-5506 Fax: 1-866-249-6155 www.ca[Phone: 1-866-814-5506 Fax: 1-866-249-6155 www.caremaCall the Pharmacy Precertification Unit: Non-Specialty 1-800-294-5979 PHONE 866-814-5506 . FAX 866-249-6155 . AllWays Health Partners—Provider Manual Appendix A Contact Information . www.allwaysprovider.org 2019-01 01 . Author: MemberName:{{MEMFIRST}}{{MEMLAST}}DOB:{{MEMBERDOB}}PANumber:{{PANUMBER}} Sendcompletedformto:CaseReviewUnit,CVSCaremarkPriorAuthorization.Fax:1-866-249-6155