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Reference Number C7036-A / Effective Date 07/01/2017 2. Is this a request for or If no then skip to question 16. Pharmacy Prior Authorization AETNA BETTER HEALTH NEVADA Anticoagulants Injectable Medicaid This fax machine is located in a secure location as required by HIPAA regulations. Replacement surgery 17. Has the patient had a therapeutic failure or intolerance to or AND 18. During acute illness thrombosis SVT of the lower limb VTE in a patient with cancer treatment of venous...

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