If you are prescribing CPAP/APAP/BiPAP for this member, medical policy requires him/her to obtain this device through Depot Drug mail order pharmacy. If you have any questions, please contact Depot Drug at 801-595-4351.
You may print and mail or fax this form to:
Depot Drug
PO Box 161020
Salt Lake City, UT 84116
Fax: 801.595.2051