South Carolina Pharmacy Services

Pharmacy • Documents

Pharmacy Documents

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Educational Tools

Title	File Size
Title	File Size
Coordination of Benefits Billing Reference Guide (effective Sept. 15, 2010)	61 KB
Coordination of Benefits Billing Reference Guide (Current policy)	57 KB
Coordination of Benefits Presentation (effective Sept. 15, 2010)	4,806 KB
Multi-Ingredient Compound Billing Reference Guide	66 KB
Multi-Ingredient Compound Submission Procedures Presentation	3,486 KB

Forms

Title
Title
Antipsychotic PA Request Form
Growth Hormone PA Request Form - Adult Treatment
Growth Hormone PA Request Form - Pediatric Treatment
Health Insurance Referral Form
Hepatitis B PA Request Form
Hepatitis C PA Request Form
MAC Price Research Request Form
Medwatch Form
Pharmacy General Prior Authorization Form

Listings

Title
Title
Maximum Drug Unit Reimbursement Rate Listing (last modified: 08/09/2010)
Pharmacy Dose Optimization Program
Pharmacy Error Codes
Pharmacy Quantity Limits
Pharmacy TPL Codes - Sorted by Name
Pharmacy TPL Codes - Sorted by Code

Manuals

Title
Title
Medicaid Provider Manual - Pharmacy Point of Sale
Medicaid Payer Specifications - Pharmacy Services
Medicaid Provider Manual - Pharmacy Services