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Pharmacy Provider Procedure Manual
P-18. Forms
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Pharmacy Provider Procedure Manual

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P-1. Introduction
P-2. Contact Information
P-3. Enrollment
P-4. Managed Care
P-5. System Requirements
P-6. Eligibility
P-7. Coordination of Benefits
P-8. Drug Policy
P-9. Formulary Coverage
P-10. Drug Utilization Review
P-11. Prior Authorization
P-12. Pricing and Reimbursement
P-13. 340B Resources
P-14. Payment
P-15. Audits
P-16. Drug Rebates
P-17. Documents
P-18. Forms

Payment Forms

Pharmacy Electronic Remittance Advice Agreement

HHS 1316
hhs.texas.gov/laws-regulations/forms/1000-1999/form-1316-pharmacy-electronic-remittance-advice-agreement

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