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Pharmacy Request for Prior Approval Vyondys 53 and ViltepsoBeneficiary Information 1. Beneficiary Last Name: ___ 2. First Name: ___ 3. Beneficiary ID #: ___ 4. Beneficiary Date of Birth: ___ 5. Beneficiary
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Who needs vyondys 53 and viltepso?

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Vyondys 53 is indicated for the treatment of Duchenne muscular dystrophy (DMD) in patients who have a confirmed mutation of the DMD gene that is amenable to exon 53 skipping.
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Viltepso is indicated for the treatment of DMD in patients who have a confirmed mutation of the DMD gene amenable to exon 53 skipping.
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These medications are specifically for individuals who have DMD with a specific genetic mutation that can be targeted by exon 53 skipping therapies.
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Vyondys 53 and Viltepso are regulatory forms used for reporting purposes related to specific pharmaceutical products or medical treatments.
Manufacturers, distributors, and other entities involved in the production and distribution of the related products are required to file Vyondys 53 and Viltepso.
To fill out Vyondys 53 and Viltepso, you must provide accurate information regarding the products, including details of production, distribution, and compliance with regulatory standards.
The purpose of Vyondys 53 and Viltepso is to ensure compliance with industry standards and regulations, and to facilitate the monitoring and reporting of the pharmaceutical products.
Information that must be reported includes product identification, production quantities, distribution channels, and any compliance issues or violations.
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