| Anthem Blue Cross (HMO, PPO, EPO) |
| sodium,potassium,mag sulfates (sodium,potassium,mag sulfates) |
| Drugs for the Stomach : Drugs to Prevent Constipation |
- Prior Authorization Required
For FAX form click HERE
Our electronic prior authorization (ePA) process is the preferred method for submitting pharmacy prior authorization requests. Creating an account is free, easy and helps patients get their medications sooner. You can complete the process through your current electronic health record/electronic medical record (EHR/EMR) system or by using one of these ePA sites:
Log in to Surescripts
Log in to CoverMyMeds;- Quantity Limit: 2 kits per 30 day(s).
|