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Date PRIOR AUTHORIZATION QUESTIONNAIREStelara () in. M.D. Last Name: Physician Phone: M.D. First Name: Physician Fax: Patient ID# DOB **FAILURE TO COMPLETE THE FORM MAY RESULT IN A DELAY OR AN AUTOMATIC
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Us tekinumab inj is a medication used for treating certain autoimmune diseases like psoriasis and psoriatic arthritis.
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Information regarding the dosage, patient's name, date of administration, any side effects, and the healthcare provider administering the medication must be reported.
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