Log in, register for an account, pay your bill, print ID cards, and more.
Log into your account, view patient information, and more.
Click the categories below for important pharmacy documents and resources.
Acaria Health Specialty Medication Referral Form (PDF)
Billing Medicaid Pharmacy LTC/SNF Claims (PDF)
CVS Caremark Specialty Pharmacy Fax Enrollment Form (PDF)
HealthierLife (HARP) Coverage and the Behavioral Health Carve-in: July 2, 2018 (PDF)
Notice on the 2018 Flu Season Medications (PDF)
Pharmacy Vaccine Coverage and Billing Guide for Medicaid, CHP and HARP (PDF)
Requesting Synagis for Fidelis Care Members (PDF)
What is Biosimilar? (PDF)
American Society of Clinical Oncology Statement: Biosimilars in Oncology (PDF)
2019 Drug Formulary (PDF)
2019 Formulary Changes (PDF)
2019 Formulary Quick Reference Guide (PDF)
2018 Formulary (PDF)
Quick reference list (PDF)
2019 Formulary (PDF)
2017 Formulary (PDF)
Prior Authorization (PA) Criteria (PDF)
Step Therapy Criteria (PDF)
Medication Request Form for Medicaid, CHP, and Qualified Health Plans (PDF)
Opioid Prior Authorization Form (PDF)
Hepatitis C Prior Authorization Form (PDF)
Medicare Medication Request Form (PDF)
Medicare Electronic Drug Coverage Determination Form
New York State Department of Health standardized prior authorization form (PDF)
Specialty Medication Prior Authorization Criteria: Medicaid, CHP, and Metal-Level Plans (PDF)
Specialty Medication Prior Authorization Criteria: Medicare (PDF)
Verify member eligibility, check claims status, and more.
Provider manuals, tip sheets, important forms, and applications.