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Office of Medical Assistance Programs FeeforService, Pharmacy Division Phone 18005378862 Fax 18663270191 ANTIMIGRAINE AGENTS, OTHER PRIOR AUTHORIZATION FORM Please submit all requested documentation
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How to fill out fee-for-service pharmacy division

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What is fee-for-service pharmacy division?
Fee-for-service pharmacy division refers to a payment model where providers are paid for each service rendered.
Who is required to file fee-for-service pharmacy division?
Pharmacy providers who operate under a fee-for-service payment model are required to file fee-for-service pharmacy division.
How to fill out fee-for-service pharmacy division?
Fee-for-service pharmacy division can be filled out by providing detailed information about the services rendered, the associated costs, and any other relevant information required by the payment model.
What is the purpose of fee-for-service pharmacy division?
The purpose of fee-for-service pharmacy division is to track and report the payments received for each service provided by the pharmacy.
What information must be reported on fee-for-service pharmacy division?
Information such as the date of service, type of service provided, associated costs, and any other required documentation must be reported on fee-for-service pharmacy division.
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