Get the Please respond below and fax this form to CVS Caremark toll-free at 1-866-237-5512

HSA Prior Authorization Request CVS Earmark administers the prescription benefit plan for the patient identified. These patients benefit plan requires prior authorization for certain medications in

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Individuals or entities meeting certain criteria may be required to file.

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You can fill it out online or submit a physical form.

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The purpose is to gather specific information for reporting and evaluation purposes.

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Specific details as instructed in the guidelines.

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