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Maryland Physicians Care 1-800-953-8854 Pharmacy Prior Authorization Prompt Fax form to 866-207-7231 HEPATITIS C THERAPY PRIOR-AUTHORIZATION FORM Incomplete form will be returned Please attach copies of the patient medical history summary lab and genetic test reports to MPC. Please review the DHMH FFS Medicaid Hepatitis C Treatment clinical guidelines before submitting this form as Maryland Physicians Care follows MD Medicaid FFS Hep C Clinical guidelines Patient Information Recipient MA Date...
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What is maryland physician care?
Maryland Physician Care is a program that provides medical care for residents of Maryland.
Who is required to file maryland physician care?
Healthcare providers who participate in the Maryland Physician Care program are required to file.
How to fill out maryland physician care?
Maryland Physician Care can be filled out online through the official website or submitted via mail or fax.
What is the purpose of maryland physician care?
The purpose of Maryland Physician Care is to ensure that residents have access to quality medical care.
What information must be reported on maryland physician care?
Details of medical services provided, patient information, and payment details must be reported on Maryland Physician Care.
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