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Prescriber Criteria Form Marigold Reeves 2022 PA Fax 3875A v1 010122.docx Reeves (selpercatinib) Coverage Determination This fax machine is located in a secure location as required by HIPAA regulations. Complete/review
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How to fill out oncologyretevmo selpercatinib capsules

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Wash your hands before handling the capsules.
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Take the capsules with a full glass of water, either with or without food.
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Follow the dosage instructions provided by your doctor or pharmacist.
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Who needs oncologyretevmo selpercatinib capsules?

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Patients diagnosed with advanced or metastatic non-small cell lung cancer who have a specific genetic mutation called RET fusion
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Oncologyretevmo selpercatinib capsules are a medication used in the treatment of certain types of cancer, specifically for patients with specific genetic mutations.
Healthcare providers and facilities are required to file oncologyretevmo selpercatinib capsules for patients who are prescribed this medication.
Oncologyretevmo selpercatinib capsules should be filled out by healthcare professionals with all pertinent patient information, dosage instructions, and relevant medical history.
The purpose of oncologyretevmo selpercatinib capsules is to target specific genetic mutations in cancer cells to inhibit their growth and spread.
Information such as patient demographics, medical history, dosage instructions, and any side effects must be reported on oncologyretevmo selpercatinib capsules.
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