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PRIOR AUTHORIZATION REQUEST Pentagon PATIENT:Prescriber:Name Address: City, State, Zip D.O.B. Member ID:Medication Requested:Name Address City, State, Zip Phone Fax Piety Requested:Your patients prescription
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Find a provider is a process of locating a qualified individual or organization offering relevant services or products.
Any individual or organization seeking to utilize services or products from a provider must file find a provider.
Find a provider can be filled out by providing relevant information about the services or products needed, desired qualifications, location preferences, etc.
The purpose of find a provider is to connect individuals or organizations with suitable service providers to meet their needs.
Information such as service/product details, qualifications, location, pricing, and contact information must be reported on find a provider.
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