Documents

Payer Sheets

MRx Commercial Payer Sheet

MRx Commercial Payer Sheet - Alliant Health Plan

MRx Commercial Payer Sheet - Cash Card

MRx Commercial Payer Sheet - Caterpillar Rx

MRx Commercial Payer Sheet - GatorCare

MRx Commercial Payer Sheet - Legacy Veridicus Rx

MRx Commercial Payer Sheet - SmartSave Rx

MRx Commercial Payer Sheet - University of Michigan

MRx Managed Medicaid - Community Care Plan and CCP Florida Healthy Kids

Hamaspik Medicare Select HMO-D SNP Payer Sheet

Legacy 4D Commercial and Managed Medicaid Payer Sheet

Mass Advantage HMO and PPO Payer Sheet

San Francisco Health Plan Payer Sheet

University of North Carolina HCS Commercial/Employees Payer Sheet

Upper Peninsula Health Plan Medicaid Payer Sheet

Upper Peninsula Health Plan Plus MMP HMO Payer Sheet

California Department of Public Health, Office of AIDS, AIDS Drug Assistance Program (CDPH/OA/ADAP) Payer Sheet

California Department of Public Health, Office of AIDS, Pre-Exposure Prophylaxis Assistance Program (PrEP-AP), (CDPH/OA/PrEP-AP) Payer Sheet

State of Connecticut Department of Public Health Connecticut AIDS Drug Assistance Program (CADAP) Payer Sheet

State of Florida Department of Health AIDS Drug Assistance Program (FLADAP) Payer Sheet

Idaho AIDS Drug Assistance Program (ADAP) and IDAGAP Payer Sheet

Massachusetts Infectious Disease Drug Assistance Programs (MA IDDAP) Payer Sheet

Nevada Medication Assistance Program (NMAP) Payer Sheet