Opsumit scripts 2026

1. Click ‘Get Form’ to open the opsumit scripts in the editor.
2. Begin by entering the member's last name, first name, SCAN ID number, and date of birth in the designated fields.
3. Fill in the prescriber’s name, contact person, office phone, office fax, medication, and diagnosis as required.
4. In SECTION A, answer each question regarding the treatment of pulmonary arterial hypertension (PAH) by selecting 'Yes' or 'No'. Provide additional information where prompted.
5. Document baseline liver function tests and hemoglobin levels in the specified areas if applicable.
6. In SECTION B, ensure that the physician signs and dates the form before submission.
7. Once completed, fax the form to 1-877-251-5896 as instructed.

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