2023 PAAS Discount Sign-Up $399

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Please use this form to sign-up for the NCODA discounted PAAS membership $399/store for PAAS Audit Assistance for 2023 with the option to add Fraud & Waste Services for an additional $507. DEADLINE to sign-up is January 2, 2023.

Email *

Pharmacy Name *

Pharmacy Address (Please provide full mailing address and do not use a PO box) *

Contact Name *

Contact Title *

Contact Email *

Phone Number *

Fax Number *

NCPDP # *

NPI # *

Add Fraud & Waste Services for additional $507 *

Yes and I understand to total charges for PAAS services billed thru NCODA will be $906

Not at this time. Please bill me for $399 PAAS Renewal

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