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Get the free Bile Salts - Cholbam Form - dhs.pa.gov

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Office of Medical Assistance Programs FeeforService, Pharmacy Division Phone 18005378862 Fax 18663270191CHOLBAM (colic acid)PRIOR AUTHORIZATION Formulas submit all requested documentation with this
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Bile salts are natural substances in bile that help with digestion. Cholbam is a medication that contains bile salts and is used to treat certain liver and bile disorders.
Healthcare providers and pharmacies are required to file information about the distribution of bile salts - cholbam.
Bile salts - cholbam information can be filled out electronically through the designated reporting system or submitted via mail with the required forms.
The purpose of reporting bile salts - cholbam is to track the distribution of this medication and ensure proper usage for patients with liver and bile disorders.
Information such as the quantity of bile salts - cholbam distributed, the date of distribution, and the receiving healthcare provider's information must be reported.
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