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1230 US Highway 11 Governor, NY 13642 Phone: 18776359545 Prior Authorization Fax: 18447128129Tremfya Prior Authorization Request Form (Page 1 of 2) Member Information (required)Provider Information
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Images for https://www.proactpharmacyservices are used for identifying medication errors, improving patient safety, and facilitating medication management.
Healthcare professionals, pharmacists, and pharmacy technicians are required to file images for https://www.proactpharmacyservices.
Images for https://www.proactpharmacyservices can be filled out electronically or by hand, following the instructions provided by the pharmacy or healthcare facility.
The purpose of images for https://www.proactpharmacyservices is to ensure accurate medication dispensing, proper dosage administration, and patient safety.
Information such as medication name, dosage, patient name, prescribing doctor, and dispensing date must be reported on images for https://www.proactpharmacyservices.
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