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MMA

Home » For Providers » Provider Tools » Pharmacy » MMA

FL Medicaid MMA Pharmacy Benefit Manager: Magellan Rx

Prime Therapeutics RX
Help Desk/Prior Authorization Phone: (800) 424-7897

Prime Therapeutics
RX Prior Authorization Fax:
(800) 424-7913

Prime Therapeutics
Specialty Pharmacy Help Desk:
(866) 554-2673

Prime Therapeutics
Specialty Pharmacy Fax:
(866) 364-2673

FL Medicaid MMA Pharmacy Locator

To locate a pharmacy for an
CCP FL Medicaid MMA enrollee

FL Medicaid MMA Preferred Drug List

FL Medicaid/ CCP Preferred Drug List (PDL), Changes Summary Report,
Drug Limitations

Prior authorization forms for
FL Medicaid MMA enrollees

Additional Drug Criteria requirements for FL Medicaid MMA enrollees

General prior authorization form for FL Medicaid MMA enrollees

For Physician Administered Drugs (J-codes)

List of Physician Administered J-codes requiring prior authorization
J-code prior authorization form

CCP Prior Authorization Fax for
J-codes/ Medical procedures:
(844) 870-0159