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OPTIMA HEALTH COMMUNITY CARE AND OPTIMA FAMILY CARE (MEDICAID) PHARMACY PRIOR AUTHORIZATION/STEPPED REQUEST* Directions: The prescribing physician must sign and clearly print name (preprinted stamps
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pasoolantramedicaid soolantra 1 topical is a topical medication used for certain skin conditions like rosacea.
Healthcare providers and pharmacies are required to file pasoolantramedicaid soolantra 1 topical for reimbursement purposes.
pasoolantramedicaid soolantra 1 topical can be filled out by providing details of the patient, prescribing physician, medication dosage, and other relevant information.
The purpose of pasoolantramedicaid soolantra 1 topical is to provide medical treatment for skin conditions like rosacea.
Information such as patient details, prescribing physician, medication dosage, and any other relevant information related to the treatment must be reported on pasoolantramedicaid soolantra 1 topical.
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