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2. Is this request for Alferon N If no then no further questions. Reference Number C6637-A / Effective Date 07/01/2017 4. 7. Is the patient e-antigen positive HBeAg positive 20 000 IU/mL bilirubin albumin hemoglobin neutrophils and platelets 11. Pharmacy Prior Authorization AETNA BETTER HEALTH NEVADA Intron A Alferon N Medicaid This fax machine is located in a secure location as required by HIPAA regulations. Is the renewal request for Intron A 26. Is this a renewal request for Intron A for...
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