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Electric, Nonhospital Grade Breast Pump Request Form (in place of prescription) Submit your completed form via an email to managedcarefax×medline.com or fax to 18662021563 For assistance, call Med
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Electric nonhospital grade breast refers to a type of medical device used for breast imaging outside of a hospital setting.
Healthcare facilities and providers who use electric nonhospital grade breast devices are required to file the necessary documentation.
To fill out electric nonhospital grade breast forms, healthcare facilities and providers must include relevant information about the device and its usage.
The purpose of electric nonhospital grade breast is to ensure the safe and proper use of medical devices for breast imaging in nonhospital settings.
Information such as device specifications, usage data, and maintenance records must be reported on electric nonhospital grade breast forms.
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