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PRIOR AUTHORIZATION REQUEST FORM BM CHP 9.304 Prescription Compounds Version 4.0 Effective Date 1/1/17 Phone: 8885660008 Fax back to: 8663055739 ENVISION RX OPTIONS manages the pharmacy drug benefit
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How to fill out 304 prescription compounds

01
Step 1: Gather all necessary information for the prescription compounds, including patient details and specific compounds required.
02
Step 2: Ensure you have the appropriate facilities and equipment for compounding medications.
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Step 3: Verify the accuracy of the prescription and review any specific instructions provided.
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Step 4: Prepare the necessary ingredients and materials for compounding the prescription compounds.
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Step 5: Follow the specific compounding instructions provided, taking note of any special considerations or precautions.
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Step 6: Measure and combine the required ingredients according to the prescription, following proper compounding techniques.
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Step 7: Dilute or adjust the concentration of the compounds as directed, if necessary.
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Step 8: Package and label the compounded prescription compounds correctly.
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Step 9: Perform quality control checks to ensure the accuracy and safety of the compounded compounds.
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Step 10: Store the completed prescription compounds in appropriate conditions until they are dispensed to the patient.

Who needs 304 prescription compounds?

01
Patients who require customized medications or have specific allergies or sensitivities may need 304 prescription compounds.
02
Healthcare providers who specialize in compounding prescriptions may require 304 prescription compounds to meet the specific needs of their patients.
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Institutions or facilities that provide healthcare services and want to ensure the availability of a wide range of customized medications may need 304 prescription compounds.
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Research institutions or laboratories that need specific compounds for scientific studies may require 304 prescription compounds.
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304 prescription compounds are medications that are prescribed by healthcare providers.
Healthcare providers and pharmacies are required to file 304 prescription compounds.
304 prescription compounds can be filled out by documenting the necessary information about the prescribed medications.
The purpose of 304 prescription compounds is to track and monitor the prescribing and dispensing of medications.
The information reported on 304 prescription compounds includes the prescribed medication, dosage, patient details, and prescribing healthcare provider.
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