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Pharmacy
User: Visitor July 25, 2008
Pharmacy Images
Provider Help Desk: (p) 888-420-9711 (f) 800-408-1088 | Member Help Desk: (p) 866-796-2463 (f) 207-287-8601
Prior Authorization (PA) Helpdesk (for Provider PA inquiries): (p) 888-445-0497 (f) 888-879-6938

Pain Management Files

(click column headers to sort)

The following files contain information and materials for use by physicians who participate in Maine's pharmacy benefits.

The information here is in MS Word format. If you cannot view a file, please download the appropriate free plug-in from the links below.

 

Name Description Date
PA Waiver Form PA Waiver Form 51 kB   7/25/2006
Pharmacy Referral Form Pharmacy Referral Form 53 kB   9/25/2006
Physician Referral Form Physician Referral Form 52 kB   9/25/2006