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2211 Sanders Road, Northbrook, IL 60062 Phone (866) 8145506Fax Transmittal Fax: Auth.OfficeContactFaxNumber To: Auth.ProviderBilling. Name. Legal From: CVS Fax: (855) 3301720 Re: Prior Authorization
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To fill out the preferred-drug-list-formulary-3-choice for CareFirst BlueChoice, follow these steps:
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Start by downloading the preferred-drug-list-formulary-3-choice form from the official CareFirst BlueChoice website.
03
Read the instructions carefully to understand the requirements and guidelines for filling out the form.
04
Provide your personal information such as name, date of birth, and contact details in the designated fields.
05
Review the list of covered drugs or medications that are included in the preferred drug list formulary.
06
For each medication you currently take or plan to take, ensure that it is listed in the formulary.
07
If a medication is not listed, consult with your healthcare provider or contact CareFirst BlueChoice for guidance on how to proceed.
08
Indicate your choices by selecting the appropriate response or checking the boxes provided.
09
Double-check your entries and make sure all the required information is provided.
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Sign and date the form, as required.
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Submit the filled out preferred-drug-list-formulary-3-choice form to the designated CareFirst BlueChoice office or follow the specified submission instructions.

Who needs preferred-drug-list-formulary-3-choice - carefirst bluechoice?

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Preferred-drug-list-formulary-3-choice - CareFirst BlueChoice is needed by individuals who are enrolled in CareFirst BlueChoice health plans and need to select their preferred drug list formulary.
02
It is typically required for individuals who require prescription medications and want to ensure that their medications are covered or included in the preferred drug list of CareFirst BlueChoice.
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The Preferred Drug List (PDL) for CareFirst BlueChoice is a list of medications that are preferred for use due to their safety, efficacy, and cost-effectiveness. It helps guide both providers and members in choosing the most appropriate medications.
Pharmaceutical manufacturers and healthcare providers who prescribe medications are typically required to file the Preferred Drug List Formulary with CareFirst BlueChoice.
To fill out the Preferred Drug List Formulary, providers should carefully complete the required sections, including patient and provider information, medication details, and any supporting documentation, before submitting it according to the guidelines established by CareFirst BlueChoice.
The purpose of the Preferred Drug List Formulary is to improve medication management, promote the use of clinically effective and cost-efficient drugs, and streamline the prescription process for both providers and patients.
Information that must be reported includes the drug name, dosage, quantity, indications for use, the provider's prescribing information, and any relevant patient health information that supports the necessity of the medication.
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