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PRIOR AUTHORIZATION FORM Perform Commercial/Medicaid Unless otherwise indicated below, authorization quantities are limited to the manufacturer recommended dosageComplete online at www.selecthealth.org/pa

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How to fill out 5 mgdl or greater

01

Gather the necessary materials, including a blood glucose meter, alcohol swab, lancet, test strip, and something to record the results.

02

Wash your hands with soap and warm water, then dry them thoroughly.

03

Insert a test strip into the meter as instructed.

04

Use the alcohol swab to clean the finger you will be testing.

05

Use the lancet to prick your finger, then gently squeeze to allow a drop of blood to form.

06

Touch the test strip to the drop of blood, making sure it fully absorbs the sample.

07

Wait for the meter to display the results, which should be 5 mg/dL or greater.

08

Record the results in a log, along with the date and time of the test.

Who needs 5 mgdl or greater?

01

People with diabetes who need to monitor their blood sugar levels, as well as healthcare professionals who are treating patients with diabetes.

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What is 5 mgdl or greater?

5 mg/dL or greater typically refers to a threshold measurement in medical tests, often indicating elevated levels of certain substances in the blood.

Who is required to file 5 mgdl or greater?

Individuals or entities that report medical or laboratory test results where blood levels of particular substances reach or exceed 5 mg/dL are required to file.

How to fill out 5 mgdl or greater?

To fill out 5 mg/dL or greater reports, the relevant data should be clearly articulated, including patient identifiers, test results, and any additional required information specified by the reporting entity.

What is the purpose of 5 mgdl or greater?

The purpose of 5 mg/dL or greater reporting is to monitor health conditions and ensure that appropriate medical responses or interventions are made for elevated blood substance levels.

What information must be reported on 5 mgdl or greater?

Information that must be reported includes the patient's identification, the specific substance measured, the value of that measurement, and the date of the test.

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