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member belongs to an optumrx pharmacy plan (non-medicare) get prior authorization fax forms for members who belong to optumrx pharmacy plans. prescribers can submit requests to the optumrx® prior authorization department by completing the applicable form (part d, unitedhealthcare or optumrx) and do not copy medication information(required) has member been on this medication in the last 180 days? this document and others if attached contain information from optumrx that is privileged, what medication(s) has the patient tried and failed? if the patient is not able to meet the above standard prior authorization requirements, please please note section 3: medication information optumrx.
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