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UTAH DEPARTMENT OF HEALTH, PRIOR AUTHORIZATION REQUEST FORM (ketoconazole) Patient name: Medicaid ID #: Prescriber Name: Prescriber NPI#: Contact person: Prescriber Phone#: Extension/Option: Fax#:
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What is utah?
Utah is a state in the western United States.
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Individuals or businesses with income sourced from Utah may be required to file a Utah tax return.
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You can fill out a Utah tax return either online through the Utah State Tax Commission website or by mail.
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The purpose of Utah tax return is to report income earned in the state and calculate any taxes owed.
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Income earned in Utah, deductions, credits, and any other relevant financial information must be reported on a Utah tax return.
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