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Criteria: P0174 Approved: 1/2018 Verified: 6/2018 Reviewed:Prior Authorization Criteria Forms form applies to Paramount Commercial Members OnlySimponi Complete/review information, sign and date. Please
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Criteria p0174 approved 1 is a set of guidelines or requirements that have been officially approved for a specific purpose.
All applicable parties or individuals who meet the criteria outlined in p0174 approved 1 are required to file it.
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The specific information to be reported on criteria p0174 approved 1 will vary depending on the requirements outlined in the document.
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