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	94 KB
Coordination of Benefits Presentation	3,254 KB
Multi-Ingredient Compound Billing Reference Guide	90 KB
Multi-Ingredient Compound Presentation	3,611 KB
Proper Submission of the Prescriber NPI	2,367 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: 03/08/2010)
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