MAC Appeals Process 

Pharmacy providers may appeal a reimbursement for a MAC generic claim and request a review of the MAC pricing. All appeals and questions regarding MAC should be directed to mac@pdmi.com.

Pharmacies contracted directly with PDMI may appeal directly to PDMI using the process provided. If the pharmacy provider is member of a chain, franchise, Pharmacy Services Administrative Organization (PSAO), or similar organization, please direct your appeals to your corporate office or third party administrator office. Corporate HQs and PSAO groups can then appeal on behalf of all their member pharmacy providers.

Please submit the MAC appeal via the procedure described below. All submissions are required in the electronic format provided. Invoices detailing the acquisition costs may be taken into consideration for the appeal, but are not required. The requesting party will receive an email response detailing whether the appeal has been approved for a price update or denied.

MAC Appeal Procedure:

  1. Fill out the provided Mac Appeal Form in its electronic format. Required fields are highlighted in yellow on the MAC Appeal Form.
    1. Fields
      1. Contact Name*
      2. Contact Email Address*
      3. Pharmacy Provider NCPDP ID or NPI#*
      4. Rx #*
      5. Fill Date*
      6. NDC*
      7. Quantity
  2. Submit the completed file to mac@pdmi.com.