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Prescriber Criteria Form Vizier 2023 PA Fax 2771A v1 010123.docx Vizier (dacomitinib) Coverage Determination This fax machine is located in a secure location as required by HIPAA regulations. Complete/review
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Obtain the Vizimpro prescription from your healthcare provider
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The Vizimpro Minnesota Department of Health is responsible for regulating and monitoring the prescription drug Vizimpro in the state of Minnesota.
Healthcare providers and pharmacies are required to file reports with the Vizimpro Minnesota Department of Health.
To fill out the Vizimpro Minnesota Department of Health report, healthcare providers and pharmacies must include detailed information about the distribution and prescription of Vizimpro.
The purpose of the Vizimpro Minnesota Department of Health report is to track the usage and distribution of the prescription drug Vizimpro in the state.
Information such as the number of Vizimpro prescriptions filled, patient demographics, and healthcare provider information must be reported on the Vizimpro Minnesota Department of Health report.
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