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Get Prior Auth For Meritus Medication Form

Eview information, sign and date. Fax signed forms to CVS/Caremark at 1-888-836-0730. Please contact CVS/Caremark at 1-800-294-5979 with questions regarding the prior authorization process. When conditions are met, we will authorize the coverage of Marketplace Exchange Exception (HMF). Drug Name (select from list of drugs shown) Other, Please specify Quantity Frequency Route of Administration Patient Information Patient Name: Patient ID: Patient Group No.: Patient DOB: Patient.

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