Date: 2014-11-20 23:47:32Patient safety Clinical pharmacology Medical prescription Medical terms Health Insurance Portability and Accountability Act Prescription medication Methadone Electronic prescribing Ohio Automated Rx Reporting System Medicine Health Pharmacology | | Page 1 of 2 PRESCRIPTION DRUG PRIOR AUTHORIZATION REQUEST FORM Plan/Medical Group Name: ________________________________ Plan/Medical Group Phone#: (_______)Add to Reading ListSource URL: www.dmhc.ca.govDownload Document from Source Website File Size: 104,03 KBShare Document on Facebook
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