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REQUEST FOR MEDICARE PRESCRIPTION DRUG COVERAGE DETERMINATION
This form may be sent to us by mail or fax:
Address:
Medicare Pharmacy Prior
Authorization Department
P.O. Box 31397
Tampa, FL 336313397Fax
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What is form i silversummit health?
Form i silversummit health is a document used for reporting health insurance coverage to the IRS.
Who is required to file form i silversummit health?
Employers who provide health insurance coverage to their employees are required to file form i silversummit health.
How to fill out form i silversummit health?
Form i silversummit health can be filled out electronically or manually, depending on the preference of the filer.
What is the purpose of form i silversummit health?
The purpose of form i silversummit health is to report the health insurance coverage provided to individuals.
What information must be reported on form i silversummit health?
Form i silversummit health requires information such as the name, address, and Social Security Number of the individual covered by the health insurance plan.
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