Your Prior Auth Dashboard


Status Patient Name Prescription Payer Updated
pharmacy New UHVKGX Ram Lakshman 04/04/1948 IL Flintstones Gummies Complete chewable tablets Express Scripts Electronic PA Form 06/23/2017 at 07:05AM
New VV9AEA Nathan Jones 10/01/1971 OH Bubbles The Fish II Pedi Mask None Chosen 06/23/2017 at 07:05AM
New UHVKGX Ram Lakshman 04/04/1948 IL Bubble Gum syrup None Chosen 06/23/2017 at 07:05AM
New CU92RD Autopick Smith 10/01/1971 OH Bubble Gum Flavor liquid Inland Empire Health Plan (IEHP) California Universal Request Form (State Mandated) 06/23/2017 at 07:05AM
New ETMMNE Autopick Smith 10/01/1971 OH Bubble Gum Flavor liquid None Chosen 06/23/2017 at 07:05AM
New YNX3LA Autopick Smith 10/01/1971 OH SpongeBob SquarePants Gummies None Chosen 06/23/2017 at 07:05AM
New JHL3TA Mike Miller 10/01/1971 OH Sprintec 28 0.25-35MG-MCG tablets None Chosen 06/22/2017 at 05:18PM
New MJCNTD Nathan Jones 10/01/1971 OH Testim 50 MG/5GM(1%) gel Cigna HealthSpring Medicare Non-Formulary Androgenic Agents Coverage Determination Form 06/22/2017 at 05:12PM
pharmacy New UHVKGX Raman Lakshman 04/04/1948 KY Flintstones Gummies Complete chewable tablets Express Scripts Electronic PA Form 06/22/2017 at 05:08PM
New C2CPN4 Amber Williams 10/01/1971 OH AndroGel 50 MG/5GM(1%) gel None Chosen 06/22/2017 at 05:05PM
New VPPP6W Autopick Smith 10/01/1971 OH SpongeBob SquarePants Gummies None Chosen 06/22/2017 at 11:46AM
New E2H38Y Autopick Johnson 10/01/1971 OH Flintstones Gummies None Chosen 06/22/2017 at 09:13AM
New DAURYW Autopick Smith 10/01/1971 OH Bubble Gum Flavor liquid None Chosen 06/19/2017 at 05:10PM