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8003. Louisiana Uniform Prescription Drug Prior Authorization FormLOUISIANA UNIFORM PRESCRIPTION DRUG PRIOR AUTHORIZATION FORM SECTION I SUBMISSIONSubmitted to:Phone:Fax:Date:SECTION II PRESCRIBER
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Section i submission is a part of the formal documentation required to be completed and submitted.
Section i submission is typically required to be filed by individuals or entities specified by the governing body.
Section i submission is typically filled out following the instructions provided by the governing body.
The purpose of section i submission is to provide specific information or data required by the governing body.
Section i submission typically requires reporting of specific data or information as outlined by the governing body.
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