For Pharmacists and Medical Professionals

TEST JM 7-18-2024 Pharmacists and Medical Professionals:

Drug Lists TEST JM 7-18-2024

Drug Safety Alerts

Medicare Part D Any Willing Provider Request

Pharmacy Pre-Enrollment Questionnaire

Pharmacy Enrollment Self Service

Emergency Response

Mail Service Numbers, Forms and Information

Specialty Pharmacy Services, Information and Forms

Prior Authorization Information

Clinical Drug Information

Clinical Programs and Health Management

Clinical Publications

FAQs for Prescribers and Office Staff

Pharmacy Help Desk

FAQs for Pharmacists and Pharmacy Staff

NY I-STOP Information

TX Medicaid Zika Pharmacy Notice

TX Medicaid Zika Prescriber Notice

Medicare Part D Compliance / Fraud, Waste, and Abuse Training for Pharmacy Staff

Provider Training for Texas Medicaid

CVS Health Code of Conduct (PDF)

CMS General Compliance and FWA Training

CVS Caremark 2017 Annual Pharmacy Attestation of Completed General Compliance/FWA Training

Training Regulations – Instructions and FAQs

Corporate Integrity Agreement (CIA) Code of Conduct for Pharmacy Staff

CVS Health Code of Conduct

Provider Credentialing

Pharmacy Re-Credentialing

ACA 42 CFR 455 Re-Credentialing

State of New York ADA Attestation

NCPDP Payer Sheets:

NCPDP Version D.0 Payer Sheet - Commercial Primary Billing (PDF)

NCPDP Version D.0 Payer Sheet - Commercial Other Payer Amount Paid Billing (PDF)

NCPDP Version D.0 Payer Sheet - Commercial Other Payer Patient Responsibility Billing (PDF)

NCPDP Version D.0 Payer Sheet - MEDD Primary and Medicare as Secondary Payer Billing (PDF)

NCPDP Version D.0 Payer Sheet - MEDD Other Payer Amount Paid Billing (PDF)

NCPDP Version D.0 Payer Sheet - MEDD Other Payer Patient Responsibility Billing (PDF)

NCPDP Version D.0 Payer Sheet - ADAP-SPAP MEDD OPPR Billing (PDF)

NCPDP Version D.0 Payer Sheet - Medicaid Primary and Secondary Payer Billing OPAP (PDF)

NCPDP Version D.0 Payer Sheet - Medicaid Primary and Secondary Payer Billing OPPR (PDF)

NCPDP Version D.0 Payer Sheet - Business for BIN 610502

NCPDP Version D.0 Payer Sheet - Reject

Downloadable Forms and Guides

State of West Virginia Public Employees Insurance Agency (PEIA)

835 Pharmacy Payment Setup/Change Form (PDF)

TrOOP Excluded Entity Patient Pay Amount Adjustment Form (PDF)

EFT New Setup/Change Request (PDF)

Teacher Retirement System of Texas (TRS-ActiveCare) Extended Day Supply Network Information

State of Connecticut Custom Maintenance Drug Network Process (PDF)

State of Connecticut Maintenance Drug Network Enrollment Information

Florida Informed Consent Form

Kentucky Employees' Health Plan Extended Days Supply Network Information

Kentucky Medicaid Network

MVP Health Care Vermont Extended Days Supply Network Information

State of Florida Employees and Retirees Extended Days Supply Network Information

MAC Price Inquiry Process Guide for Puerto Rico

Kentucky and Oklahoma Pharmacy MAC List Request

Blue Shield of California MAC List Request Form

Web Portal MAC Price Access

Medicaid Specialty Pharmacy Request Form - PA