Formulary And Clinical Documents
MAC Support
Magellan Medicaid Administration, Inc.
Attn: State MAC Department
Mail: 11013 West Broad Street, Glen Allen, VA 23060
Fax: 1‐888‐656‐1951
E‐mail: StateMACProgram@primetherapeutics.com
Website: https://minnesota.primetherapeutics.com/
Providers may request a MAC price review by filling out the MAC Price Research Request Form and submitting it to the vendor via fax or email. All inquiries must be accompanied by actual invoices from the provider’s wholesaler for consideration. All efforts will be made to respond to requests within three business days; however, a complete review will be delayed if an incomplete form is provided and/or an invoice is not submitted.