 |
 |
 |
 |
 |
 |
|
 |
 |
|
 |
|
||||||
|
|
 |
|||||||||
|
MAC Price Inquiry This form has been created for use by retail pharmacies. It provides an opportunity to indicate any difficulty a pharmacy may have in obtaining a specific drug at the Maximum Allowable Cost price provided by US Script and is the sole means by which to communicate requests for price reviews. The information you provide in this form is necessary to complete a price review. Accordingly, please complete this form in its entirety. Failure to include all required fields may result in either our inability to respond to pricing inquiries in a timely manner, or our inability to provide any response.
Please include the word "MAC" in your subject line of your email when sending the above form to us.
|
|||||||||||
 |
|||||||||||
|
|||||||||||
