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Prior Authorization Request Form For Atypical Antipsychotic Agents only Kentucky MedicaidMental Health Drug Fax this request to: (800) 3658835Questions? Call Magellan Medicaid Administration at (800)
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What is fax this request to?
Fax this request to the designated fax number provided by the recipient.
Who is required to file fax this request to?
The individual or organization requesting the information is required to file the fax request.
How to fill out fax this request to?
Fill out the fax request form with the required information and include any supporting documents.
What is the purpose of fax this request to?
The purpose of faxing the request is to formally submit a written request for information.
What information must be reported on fax this request to?
The fax request should include details such as the sender's contact information, the requested information, and any specific instructions.
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