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Page 1 of 2 PRESCRIPTION DRUG PRIOR AUTHORIZATION REQUEST FORM Plan/Medical Group Name: Medical. A. Care Health Plan/Medical Group Phone#: (844) 2689786 Plan/Medical Group Fax#: (855) 8789209 Instructions:
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P D Rug P stands for Prescription Drug Pricing Program.
Manufacturers of prescription drugs are required to file P D Rug P.
P D Rug P can be filled out online on the official website designated for filing.
The purpose of P D Rug P is to ensure transparency in prescription drug pricing and reporting.
Manufacturers need to report the average sales price and other pricing data for their prescription drugs.
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