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MedicationPriorAuthorizationForm (OnabotulinumtoxinA) () (rimabotulinumtoxinB) (incobotulinumtoxinA) PolicyNumber:1042PolicyHistory Approve Date:12/11/2015 Reiterates:7/7/2016,10/18/2016,11/29/2016NextReview:

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What is facialnerveviidystonia?

Facial nerve viidystonia is a medical condition that affects the facial nerves.

Who is required to file facialnerveviidystonia?

Patients diagnosed with facial nerve viidystonia are required to file this condition.

How to fill out facialnerveviidystonia?

To fill out facial nerve viidystonia, one must provide details of their diagnosis and treatment plan.

What is the purpose of facialnerveviidystonia?

The purpose of facial nerve viidystonia is to track and monitor the condition of the facial nerves.

What information must be reported on facialnerveviidystonia?

Information such as diagnosis details, treatment plan, and progress updates must be reported on facial nerve viidystonia.

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