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Texas Standard Prior Authorization Request Form for Prescription Drug Benefits NOFR002 0615Texas Department of InsurancePlease read all instructions below before completing this form. Please send
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To fill out the intended use, follow these steps:
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Start by identifying the purpose or objective for which the product or service is being developed.
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Clearly describe the features and functions of the product or service and how it will be used by the end-users.
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Specify any limitations or restrictions on the use of the product or service.
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Provide any additional information or details that are relevant to the intended use.
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Review and revise the intended use statement to ensure it accurately reflects the purpose and scope of the product or service.

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- End-users: To have a clear understanding of how the product or service should be used to maximize its benefits and avoid misuse.
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Intended use refers to the planned purpose or function of a product or service.
The manufacturer or provider of the product or service is required to provide the intended use.
To fill out the intended use, one needs to clearly state the purpose or function of the product or service.
The purpose of stating the intended use is to ensure that the product or service is used safely and appropriately.
The information reported should clearly describe the intended purpose, function, or use of the product or service.
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