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BlueChoiceSCMedicaid.com BlueChoice HealthPlan is an independent licensee of the Blue Cross and Blue Shield Association. BlueChoice HealthPlan has contracted with Amerigroup Partnership Plan LLC an independent company for services to support administration of Healthy Connections. CONTAINS CONFIDENTIAL PATIENT INFORMATION Complete form in its entirety and fax to Prior Authorization of Benefits PAB Center at 1-866-807-6241 1. Yes No Patient has been receiving and is maintained on a stable dose...
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