Clinical Coverage Determinations
Certain drugs with special indications require authorization. These drugs are noted on the formulary. The prescribing Practitioner is responsible for obtaining the necessary authorization from Express Scripts before the drug is dispensed.
Express Scripts, Inc.
Attn: Medicare Reviews
P.O. Box 66571
St. Louis, MO 63166-6571
If Express Scripts has made an adverse determination for a medication or pharmaceutical product, you may initiate a pharmacy redetermination. This must be in writing and can be faxed to 1-877-328-9799.
Please call 1-844-648-9628 for an expedited redetermination request.