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2011 MEDICARE PART D QUANTITY LIMIT PHYSICIAN FAX COMMONLY the prescriber may complete this form. The following documentation is REQUIRED. Incomplete forms will be returned for additional information.
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Formulary information is a list of prescription medications covered by a specific health insurance plan.
Health insurance companies are required to file formulary information.
Formulary information can be filled out by providing the list of prescription medications covered, along with any restrictions or limitations.
The purpose of formulary information is to inform policyholders of the medications covered by their insurance plan.
The formulary information must include the names of covered medications, any restrictions or limitations, and cost-sharing information.
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