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Circle Yes or Y N If no then skip to question 7 3. Has the patient had an inadequate response with a 3 months trial of at maximum tolerated doses Reference Number C6550 A/ Effective Date 02/01/2017 of at maximum tolerated doses at a maximum tolerated dose If yes list medication s tried or a tricyclic antidepressant i.e. or neuropathic pain If no then no further questions of at least 1 additional formulary agent other than such as topical capsaicin tricyclic antidepressants or additional...

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