Pharmacy Services

Contacts

• LACDMH Pharmacy Services Contacts List (last updated 9/2023)

 

Pharmacy List

• LACDMH Network Pharmacies List (last updated 8/2023)

 

Medication Formulary

• LACDMH Formulary (last updated 1/2023)
  
• LACDMH Prior Authorization (PA) Request Form (last updated 10/2019) for Non-Formulary and Restricted Formulary Medications

 

Medication Access Programs

• Prescription Drug Coverage through LACDMH-Magellan
  Eligibility Criteria:
  1. Client is uninsured (i.e. has no active Medi-Cal, Medicare Part D, or other third-party prescription drug coverage)AND
  2. Client has at least 1 open episode in AVATAR AND
  3. If the most recent episode was opened > 3 months ago, client has received documented LACDMH service(s) within the last 3 months

If a client meets above criteria, either client, prescriber, prescriber’s staff, or retail pharmacy staff, may contact LACDMH-Magellan’s Customer Call Center at 800-424-6811 to obtain or renew a Magellan ID number for client. Network retail pharmacies will need the following information to process prescription drug claims for client.

• • Magellan ID# __________
  • RxBIN: 016523
  • RxPCN: 52268989
  • RxGRP: LACOUNTY

• Medicare Copay Assistance
  • Medicare Part D Extra Help program

 

PHI Fax Cover Sheet

• LACDMH PHI Fax Cover Sheet (last updated 7/2016)

 

Ordering Clinic Stock Medications and Supplies from LACDMH Pharmacy Warehouse (for LACDMH Staff Only)

• Refer to LACDMH’s Pharmacy and Laboratory Services Sharepoint site for more information

 

Where to Dispose of Unused Medications

• California State Board of Pharmacy’s Drug Take-Back Site Locator

 

Prescription Pad Request (for LACDMH Staff Only)

• Refer to LACDMH’s Pharmacy and Laboratory Services Sharepoint site for more information

 

Page last updated: 09/20/2023