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DEPARTMENT OF HEALTH SERVICES Division of Health Care Access and Accountability F00694A (12/12)STATE OF WISCONSIN DHS 107.10(2), Wis. Admin. CodeFORWARDHEALTHPRIOR AUTHORIZATION / PREFERRED DRUG LIST

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What is f-00694a 1212?

f-00694a 1212 is a specific form used for reporting financial information to the relevant authority.

Who is required to file f-00694a 1212?

Individuals or entities with certain financial activities are required to file f-00694a 1212.

How to fill out f-00694a 1212?

f-00694a 1212 should be filled out following the instructions provided by the relevant authority.

What is the purpose of f-00694a 1212?

The purpose of f-00694a 1212 is to collect financial information for regulatory or compliance purposes.

What information must be reported on f-00694a 1212?

f-00694a 1212 requires reporting of specific financial details as outlined by the relevant authority.

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