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Please complete ALL information below and fax your request to 18886715285Prolia Prior Authorization Request Form (Page 1 of 2) DO NOT COPY FOR FUTURE USE. FORMS ARE UPDATED FREQUENTLY AND MAY BE BARCODEDMember
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FutureScripts is a pharmacy benefit management organization that offers prescription drug plans.
Pharmacy benefit managers and prescription drug plan sponsors are required to file with FutureScripts.
To fill out forms for FutureScripts, you can visit their website or contact their customer service for guidance.
The purpose of FutureScripts is to manage prescription drug benefits and provide access to affordable medications for members.
Information such as drug utilization data, member enrollment, and prescription claims data must be reported to FutureScripts.
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