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General prior authorization request form. Refill and manage your prescriptions online, anytime. 5am to 10pm pacific / sat: Antitussives (pa age <18) capcof (phenylephrine/chlorpheniramine/codeine) 240 ml/fill, 2 fills/60 days coditussin dac. Learn how to request prior authorization for.
Do not copy for future use. 5am to 10pm pacific / sat: Antitussives (pa age <18) capcof (phenylephrine/chlorpheniramine/codeine) 240 ml/fill, 2 fills/60 days coditussin dac. General prior authorization request form. Refill and manage your prescriptions online, anytime. Optum rx is an online platform that allows you to manage your prescriptions anytime and anywhere. Covermymeds is optumrx prior authorization forms’s preferred method for receiving epa requests. Learn how to request prior authorization for.