Prescription Drugs that Require Prior Authorization
The medications listed below require prior authorization by Blue Cross & Blue Shield of Mississippi to be covered under your patient's Benefit Plan. Network Physicians are responsible for submitting a prior authorization directly to Blue Cross & Blue Shield of Mississippi.
Providers should contact the Prescription Drug Service Center by phone at 601-664-4998 or 800-551-5258.
| Medication -- Providers must submit the General Prior Authorization Form for the prescription drugs listed below. |
| Actiq |
Anabolic Steroids |
| Androgenic Steroids |
Avita |
| Celebrex 400mg |
Ceredase |
| Chorionic Gonadotropins |
Differin |
| Fentora |
Iplex |
| Lupron |
Onsolis |
| Progesterone Gels |
Provenge |
| Retin-A |
Zoladex |
| 
