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Has the provider reviewed the REMS requirements and confirmed that the patient is appropriate for medications that should not be used with Note Patient should not be taking Statin greater than 10mg Class I/III antiarrhythmics. Pharmacy Prior Authorization MERCY MARICOPA INTEGRATED CARE TXIX/XXI SMI MEDICAID Medicaid This fax machine is located in a secure location as required by HIPAA regulations. Has the patient experienced an inadequate treatment response or intolerable side effects to or...

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