RESTAT Center header Independence, Technology, Responsiveness, and Savings for over 20 years
XpertRX




 

FORMS

Prescription Drug Claim:
Prescription Drug Claim Form (PDF)

Preferred Product List:
Preferred Product Formulary - February 2010 (PDF)

Preferred Product List: By Therapeutic Class
Preferred Product Formulary: By Therapeutic Class (PDF)

RESTAT'S Step Therapy Guidelines
Step Therapy Brochure (PDF)






[Get Acrobat Reader]
Adobe® Acrobat® Reader is a software that lets you view and print Adobe Portable Document Format (PDF) files. Available free at http://www.adobe.com.

  Home vline Site Map vline Privacy Policy 800.926.5858 RESTAT vline Prescription Benefit Managers vline Copyright© 2009