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3569 Business Center Dr, Suite 175 Pearland, TX 77584 Phone: (888) 489-0038 Fax: (877) 674-0389 12/30/2022 PA Approved - TransferredCVS Specialty Pharmacy (1-800-237-2767 OR 1-866-387-2573) YES Provider Network: 866-560-4042 (Options in order 5, 7) OR Pharmacy Customer Service 602-778-1800 (Options in order 5, 5) CHP All See Mercy Care YES See Mercy Care MOLINA HEALTHCARE Central Any contracted pharmacy YES Molina Contact Center: • Call 800-424-5891106-37207A 031824 Plan member privacy is important to us. Our employees are trained regarding the appropriate way to handle members’ private health information.To obtain a prior authorization, providers may contact CVS Caremark at 866-387-2573. Provider-administered (medical benefit) Covered under the medical benefit and subject to office charges. Medications are usually administered by intramuscular injection or intravenous injection or infusion.

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For new prescriptions, your doctor can send a request via fax 1-866-329-2779 or may place a call to a registered pharmacist at 1-866-782-2779. The prescription may also be filled by completing a Patient Profile Form. Existing prescriptions may be filled by calling 1-866-387-2573. DELTA DENTAL (Dental)specialty drug: mbr call 866-387-2573 product/service not appropriate for this location drug requires prior authorization . created date: 5/20/2020 2:15:04 pm ...

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Thank you for sharing your email address. You will be receiving an email from CVS/caremark soon.

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3569 Business Center Dr, Suite 175 Pearland, TX 77584 Phone: (888) 489-0038 Fax: (877) 674-0389 12/30/2022 PA Approved - TransferredMany of us hate hearing the word “No.” And many of us don’t like saying it either. You might be especial Many of us hate hearing the word “No.” And many of us don’t like saying it ...Thank you for sharing your email address. You will be receiving an email from CVS/caremark soon.specialty drug: mbr call 866-387-2573 product/service not appropriate for this location drug requires prior authorization . created date: 5/19/2020 3:33:20 pm ... Specialty Pharmacy at 1-866-387-2573. For most specialty drugs, the contracted specialty drug mail-order pharmacy is required. • These drugs must be filled via the CVS Specialty Pharmacy. Call 1-866-387-2573. • Specialty drugs that are essential health benefits and obtained from in-network retail and mail order locations

Specialty Pharmacy at 1-866-387-2573. For most specialty drugs, the contracted specialty drug mail-order pharmacy is required. • These drugs must be filled via the CVS Specialty Pharmacy. Call 1-866-387-2573. • Specialty drugs that are essential health benefits and obtained from in-network retail and mail order locations10970 Shadow Creek Pkwy, Suite 110.1 Pearland, TX 77584 Phone: (832) 284-4933 Fax: (888) 383-2140 01/13/2020 PA Approved

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EXACTUS PHARMACY SOLUTIONS INC Tampa, FL 1-866-458-9246 CVS CAREMARK SPECIALTY PHARMACY 3 locations Nationwide (CA, KS, PA) 1 -800 237 2767 or 1-866-387-2573 Letters will be mail March 1, 2019 to impacted members and providers. Phone calls to impacted members to assist with the transfer process to a new Specialty Pharmacy will begin March 4, 2019.

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