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Perjeta SGM - 7/2017. CVS Caremark Prior Authorization 2211 Sanders Road NBT-6 Northbrook IL 60062 Phone 1-844-387-1435 Fax 1-844-851-0882 www. Perjeta Prior Authorization Request CVS Caremark administers the medical drug prior authorization program on behalf of Harvard Pilgrim Health Care. Additional Demographic Information Please indicate the place of service for the requested drug Ambulatory Surgical Home Inpatient Hospital Office Outpatient Hospital Pharmacy Criteria Questions What is...

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To fill out Perjeta - Harvard Pilgrim, follow these steps: 1. Obtain the Perjeta - Harvard Pilgrim form from the official website or your healthcare provider. 2. Carefully read the instructions and any accompanying information provided with the form. 3. Provide your personal information, including your full name, address, date of birth, and contact details. 4. Fill out the necessary medical information, including your medical history, current medications, and any relevant diagnoses. 5. If applicable, provide information about your healthcare provider and any other healthcare professionals involved in your treatment. 6. Review the completed form to ensure all information is accurate and complete. 7. Submit the filled-out form as instructed, either by mail, fax, or via the online submission portal. 8. Keep a copy of the completed form for your records. 9. If you have any questions or need further assistance, contact the Perjeta - Harvard Pilgrim helpline or customer support.

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Perjeta - Harvard Pilgrim is typically needed by individuals who meet certain criteria determined by their healthcare provider or insurance plan. This medication is primarily prescribed for the treatment of HER2-positive breast cancer in combination with other appropriate therapies. It may be recommended for individuals who have been diagnosed with early-stage breast cancer, locally advanced breast cancer, or metastatic breast cancer that is HER2-positive. It is important to consult with your healthcare provider to determine if Perjeta - Harvard Pilgrim is necessary for your specific condition and treatment plan. They will evaluate your medical history, conduct diagnostic tests, and consider other factors to determine the appropriate treatment options for you.

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What is perjeta - harvard pilgrim?

Perjeta - Harvard Pilgrim is a prescription medication used to treat certain types of breast cancer.

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Perjeta - Harvard Pilgrim is typically prescribed by a healthcare provider and filled by a pharmacy for the patient.

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Perjeta - Harvard Pilgrim is typically administered by a healthcare provider in a medical setting.

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The purpose of Perjeta - Harvard Pilgrim is to target and destroy cancer cells in the body.

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Information such as patient name, dosage, administration date, and any side effects must be reported on Perjeta - Harvard Pilgrim.

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