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Mall-group plan), Tufts Health Forward (Commonwealth Care), Tufts Health Extend, and Network Health Choice (an individual and small-group plan). Participating providers should use this form to request authorization for medications that do not require a drug-specific authorization form. Please call us at 888-257-1985 with any questions about medication requests. Review criteria We use the following criteria in reviewing medication requests: 1. The use of Preferred Drug List (PDL) drugs is contrai.

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