State of Maine Department of Human Services
Feb 11, 2016 · State of Maine Department of Health & Human Services. MaineCare/MEDEL Prior Authorization Form. PROTON PUMP INHIBITORS. Phone: 1-888-445-0497 www.mainecarepdl.org Fax: 1-888-879-6938. Prior authorization is not required for the preferred proton pump inhibitors (PPI) for a cumulative 60-days of therapy per 12-months. ... ................
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