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11/02/2015 Prior Authorization AETNA BETTER HEALTH OF ILLINOIS MEDICAID DPP4 Inhibitors (IL88) This fax machine is located in a secure location as required by HIPAA regulations. Complete/review information,
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Start by gathering all the necessary information about the drug that needs to be filled out.
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The drug name specify drug is specified as Xanax.
The manufacturer of Xanax is required to file the drug name.
To fill out the drug name specify drug, the manufacturer needs to provide detailed information about Xanax.
The purpose of drug name specify drug is to accurately identify and track the manufacturing of Xanax for regulatory purposes.
The information to be reported on drug name specify drug includes the manufacturer's name, address, dosage strength, and batch number of Xanax.
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2015 ILLINOIS AETNA IL88 XR Prescriber DPP NPI ketoacidosis ICD HIPAA contraindications DOB acidosis creatinine affirm Prescribing Inhibitors adverse MEDICAID Metabolic mg dL specify dysfunction rated AB generic Renal

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