Optumrx mail order form

The advantages of the OptumRxTM Mail Service Pharmacy. You can also complete the form and mail to OptumRx at P.O. Immediately notify the sender, or OptumRx by . Prescription Mail-In Form Mail with the original prescription(s) to OptumRx using the attached envelope.

You must enroll with OptumRx before any mail service prescriptions can be filled. All checks must be signed and made payable to: OptumRx.

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