![Plastic surgery / Health Insurance Portability and Accountability Act / Fax / Medicine / Protected health information / Law / Technology / Neurotoxins / Botulinum toxin Plastic surgery / Health Insurance Portability and Accountability Act / Fax / Medicine / Protected health information / Law / Technology / Neurotoxins / Botulinum toxin](https://www.pdfsearch.io/img/dd51d54831c53354dfef0632a906f60b.jpg) Date: 2014-03-31 16:22:23Plastic surgery Health Insurance Portability and Accountability Act Fax Medicine Protected health information Law Technology Neurotoxins Botulinum toxin | | Passport Health Plan Prior Authorization Myobloc®, Dysport®, or Botox® Note: Form must be completed in full. An incomplete form may be returned. Information on this form is protected health information and subject to Add to Reading ListSource URL: www.passporthealthplan.comDownload Document from Source Website File Size: 157,56 KBShare Document on Facebook
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