Zoloft Prior Authorization Resources

Find the right PA form for your patient's payer, get the ICD-10 codes you need, and download appeal templates — all in one place.

Amerigroup - Antidepressants Prior Authorization of Benefits FormAmerigroup
AmeriHealth Caritas Pennsylvania - Antidepressants Prior Authorization FormAmeriHealth Caritas Pennsylvania
Blue Cross Blue Shield of Arkansas - Pharmacy Prior Authorization Form Arkansas Blue Cross Blue Shield
Arkansas Blue Cross Blue Shield - Medicare Advantage Prior Authorization RequestArkansas Blue Cross Blue Shield
Blue Cross of Idaho - General Prior Authorization Form Blue Cross of Idaho Health Services, Inc.
Blue Shield of California - Non-Formulary Exception and Quantity Limit Exception FormBlue Shield of California

ICD-10 codes for Zoloft Prior Authorizations

F32.9Major depressive disorder, single episode, unspecified
F42Obsessive-compulsive disorder
F41.0Panic disorder [episodic paroxysmal anxiety]
F43.10Post-traumatic stress disorder, unspecified
F40.10Social phobia, unspecified
N94.3Premenstrual tension syndrome

Support for Getting Your Patient on Zoloft

Check coverage & formulary statusVerify PA requirements for your patient's plan.Find savings programsCopay cards, patient assistance, and more.Check medication interactionsScreen prescriptions for harmful drug combinations.