Get the free Requested Drug Name Xofigo (radium Ra 223 dichloride) - rmhp
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UNIFORM PHARMACY PRIOR AUTHORIZATION REQUEST FORM CONTAINS CONFIDENTIAL PATIENT INFORMATION Complete this form in its entirety and send to Rocky Mountain Health Plans at 858-357-2538 Urgent 1 Non-Urgent
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What is requested drug name xofigo?
Xofigo is a drug used to treat prostate cancer that has spread to the bones.
Who is required to file requested drug name xofigo?
The manufacturer or distributor of Xofigo is required to file the necessary regulatory documents.
How to fill out requested drug name xofigo?
The required information for Xofigo can be filled out on the designated regulatory forms provided by the appropriate authorities.
What is the purpose of requested drug name xofigo?
The purpose of Xofigo is to help treat and manage prostate cancer that has metastasized to the bones.
What information must be reported on requested drug name xofigo?
Information such as dosages, side effects, contraindications, and efficacy data must be reported for Xofigo.
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