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Office of Medical Assistance Programs FeeforService, Pharmacy Division Phone 18005378862 Fax 18663270191QUANTITY/DAILY DOSE/DURATION LIMITS PRIOR AUTHORIZATION FORM (form effective 01/05/2021) Prior
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How to fill out quantity limitsdaily dose limits

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To fill out quantity limits daily dose limits, follow these steps:
02
Determine the specific medication or substance for which you want to establish quantity limits and daily dose limits.
03
Consult the relevant guidelines or regulations to understand the recommended or maximum quantity limits and daily dose limits for that medication or substance.
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Take into account any specific factors such as patient age, condition, or other relevant considerations that may impact the quantity limits and daily dose limits.
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Based on the above information, set the appropriate quantity limits and daily dose limits for the medication or substance.
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Clearly document and communicate the established quantity limits and daily dose limits to healthcare professionals, patients, or any other relevant stakeholders.

Who needs quantity limitsdaily dose limits?

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Quantity limits and daily dose limits are typically needed for medication or substances that have the potential for abuse, addiction, or overdose.
02
Healthcare organizations, pharmacies, and prescribers often implement quantity limits and daily dose limits to promote patient safety, prevent misuse or overuse of medications, and comply with regulatory requirements.
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Additionally, individuals with chronic pain conditions or those who require long-term medication therapy may also benefit from quantity limits and daily dose limits to ensure appropriate and safe use of medications.
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Overall, anyone involved in the prescribing, dispensing, or monitoring of medications can benefit from quantity limits and daily dose limits to improve patient care and prevent adverse events.
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Quantity limits and daily dose limits refer to restrictions placed on the amount of medication that can be prescribed to a patient within a certain timeframe, often set by insurance companies or regulatory bodies to prevent misuse.
Healthcare providers, such as physicians and pharmacists, are typically required to file quantity limits and daily dose limits when prescribing or dispensing medications.
To fill out quantity limits and daily dose limits, healthcare providers must include the prescribed medication, the quantity prescribed, the duration of treatment, and any relevant patient information on the prescription form or electronic submission.
The purpose of quantity limits and daily dose limits is to ensure safe use of medications, reduce the risk of abuse or misuse, and manage healthcare costs by preventing overprescribing.
The information that must be reported includes patient's details, medication name, dosage, quantity prescribed, duration of therapy, and the prescriber's information.
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