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Office of Medical Assistance Programs FeeforService, Pharmacy Division Phone 18005378862 Fax 18663270191 () PRIOR AUTHORIZATION FORM Please submit all requested documentation with this request. Incomplete

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What is fee-for-service pharmacy division?

Fee-for-service pharmacy division is a division that offers pharmaceutical services to customers for a fee, rather than being part of a managed care organization.

Who is required to file fee-for-service pharmacy division?

Pharmacies that operate on a fee-for-service model are required to file fee-for-service pharmacy division.

How to fill out fee-for-service pharmacy division?

To fill out fee-for-service pharmacy division, pharmacies need to report detailed information about the services provided, fees charged, and other relevant financial data.

What is the purpose of fee-for-service pharmacy division?

The purpose of fee-for-service pharmacy division is to track and account for the services provided by the pharmacy and the fees charged for those services.

What information must be reported on fee-for-service pharmacy division?

Pharmacies must report information such as the number of prescriptions filled, services provided, fees charged, and any other relevant financial data on fee-for-service pharmacy division.

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