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I'm requesting assistance with the following issue related to Eagle Pharmaceuticals INJECTION (nonalcohol formula)*: Verification of Insurance Benefits/Drug Coverage Coding Question (i.e. HOPES, National
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Write the date in the designated field. This is typically located at the top right corner of the check.
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04
Write the amount of money you wish to pay in both numerical and written formats. For example, if you are paying $100, write it as '100.00' in numbers and 'One Hundred Dollars' in words.
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Optionally, you can write a memo in the memo field to provide additional information or notes about the payment.
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