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NDC/J Code Combination Request Formulas complete and email to: MIHMSRateChangeRequest.HHS Maine.gov×Date: Provider (Requester) Name: Provider (Requester) NPI: Contact Name: Contact Phone Number:
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The NDC/J Code Combination Request - mainecare maine is a fillable form in MS Word extension that should be submitted to the specific address in order to provide some information. It needs to be completed and signed, which is possible in hard copy, or via a certain software e. g. PDFfiller. This tool lets you fill out any PDF or Word document right in the web, customize it according to your needs and put a legally-binding electronic signature. Right after completion, the user can send the NDC/J Code Combination Request - mainecare maine to the relevant recipient, or multiple ones via email or fax. The blank is printable as well from PDFfiller feature and options proposed for printing out adjustment. Both in electronic and in hard copy, your form will have a organized and professional look. You may also save it as the template for later, without creating a new blank form over and over. You need just to amend the ready sample.

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A NDCJ code combination request is a form used to request a specific combination of NDCJ (National Drug Code Directory) codes for a product or drug.
Manufacturers, distributors, or marketing authorisation holders are required to file ndcj code combination requests.
To fill out a ndcj code combination request, the requester must provide detailed information about the product, including NDCJ codes and requested combination.
The purpose of a ndcj code combination request is to obtain a unique combination of NDCJ codes for a specific product to track and identify it accurately in the market.
The requested combination of NDCJ codes, product name, manufacturer details, and details regarding the product's formulation must be reported on a ndcj code combination request.
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