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To obtain this valuable service, simply fill out this form and return to PSI via fax, mail, phone or e-mail. You will save significantly compared to purchasing the service at the time of an audit. If you need more information, contact PSI at 800-678-2774, ext. 223 or 253.

Click Here For Your PAS Brochure

 

Pharmacy Name: _________________________________________________________

Address: ________________________________________________________________

City: ___________________________________________________________________

State: ____________________________ Zipcode: ______________________________

Phone #: ________________________________________________________________

NABP #: _________________________________________________________________

NPI #: ___________________________________________________________________

Your Name: _______________________________________________________________

 

PAS Fee Schedule*
(renewed annually on Sept. 1)
1 Pharmacy
$199.00/year
2 Pharmacies
$249.00/year
3 Pharmacies
$289.00/year
4 Pharmacies
$319.00/year
5 Pharmacies
$339.00/year
6+ Pharmacies
$359.00/year
PAS Non-members (If currently involved in or aware of an upcoming audit)
$750.00/year

 

Hourly fee after initial five hours of service: $75

   
Payment Options
Check payable to PSI
Visa/MasterCard
Name on Card: ____________________________________________________________
Credit Card Number: ________________________________________________________
Expiration Date: ____________________________________________________________
Security Code: ______________________________________________________________

Signature: __________________________________________________________________

 

Send to: For more information, contact:
Pharmacy Services Inc. 1-800-678-2774, ext. 253
815 N. Washington Ave. Fax: (517) 853-6591
Lansing, MI 48906 Email:info@pharmacyservicesonline.com

 

 

 

The Pharmacy Audit Service™ cannot eliminate audits, but it can provide guidance so that you are well informed and prepared for them.

*PSI Co-op Buying Group Members receive a 30% discount !

 

Updated: March 31, 2008