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(Revised 12/2022)PRESCRIPTION DRUG PRIOR AUTHORIZATION OR STEP THERAPY EXCEPTION REQUEST FORM
Plan/Medical Group Name: Blue Shield of California ___
Plan/Medical Group Fax#: (_844__)_2625611___Plan/Medical
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What is provider forms - promise?
Provider forms - promise are documents used by healthcare providers to attest their commitment to certain standards and to report specific information as required by regulatory bodies.
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