Forms and Documents


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MHCP Provider Manual
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Oncology Drug List Oct 2025
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Payer Specifications
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IHS Pharmacy Prescription Drug Prior Authorization Request Form
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Medical Prior Authorization Form
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Prescription Drug Prior Authorization Request Form
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Prescription Drug Reconsideration Request Form
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Synagis Prior Authorization Request Form
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Value-Based Supplemental Rebate Agreement Template
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Important Pharmacy Notice of Go Live Postponement
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November MHCP Pharmacy Module Modernization Project Stakeholder Meeting
View PDF Document
Download Document
MHCP Provider Manual
View PDF Document
Download Document
Oncology Drug List Oct 2025
View PDF Document
Download Document
Payer Specifications
View PDF Document
Download Document
IHS Pharmacy Prescription Drug Prior Authorization Request Form
View PDF Document
Download Document
Medical Prior Authorization Form
View PDF Document
Download Document
Prescription Drug Prior Authorization Request Form
View PDF Document
Download Document
Prescription Drug Reconsideration Request Form
View PDF Document
Download Document
Synagis Prior Authorization Request Form
View PDF Document
Download Document
Value-Based Supplemental Rebate Agreement Template
View PDF Document
Download Document
Important Pharmacy Notice of Go Live Postponement
View PDF Document
Download Document
November MHCP Pharmacy Module Modernization Project Stakeholder Meeting
View PDF Document