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PLEASE TAKE THIS INSERT TO THE PHARMACY Injured Workers First Fill Prescription Information SheetInjured Worker Name: Social Security #: Date Of Injury: Dear Injured Worker, On your first visit, please

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What is ccrxfirst fill template?

The ccrxfirst fill template is a form used to report first fill information for medication prescriptions.

Who is required to file ccrxfirst fill template?

Pharmacy providers are required to file the ccrxfirst fill template.

How to fill out ccrxfirst fill template?

The ccrxfirst fill template can be filled out electronically or manually by entering relevant prescription information.

What is the purpose of ccrxfirst fill template?

The purpose of the ccrxfirst fill template is to track and report first fill information for medication prescriptions.

What information must be reported on ccrxfirst fill template?

Information such as patient name, prescription number, medication name, and quantity dispensed must be reported on the ccrxfirst fill template.

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