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Fillable Commercial Prescription Drug Claim Form
Name

paper_claim_for m

Commercial. Prescription Drug Claim Form. Aetna Pharmacy Management. Attn: Claim Processing. PO Box 14024. Lexington, KY 40512-4024. FAX: 1-859-425-3371




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California Colorado false RX YYYY Aetna Birthdate DAW GC-1360 insurer claimant Lexington NABP R-POD Rico attests policyholder misrepresentation materially


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