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3569 Business Center Dr, Suite 175 Pearland, TX 77584 Phone: (888) 489-0038 Fax: (877) 674-0389 12/30/2022 PA Approved - Transferred

• To transfer your prescription, call CVS at 866-387-2573 • For a new prescription, your doctor can send the order to CVS one of three ways: • Electronically through e-prescribe • Fax: 866-329-2779 • Phone: 866-782-2779, option 2 PrudentRx Copay Program 2024 Benefits Guide

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Money Network Account Services, LLC A First Data Company GH-52 5565 Glenridge Connector, N.E. Atlanta, Georgia 30342. 1-866-387-5146. Terms & Conditions

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To obtain a prior authorization, providers may contact CVS/caremark at 866-387-2573. Provider-administered (medical benefit) Covered under the medical benefit and subject to office charges. Medications are usually administered by intramuscular injection or intravenous injection or infusion.

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