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FAX 833.329.4738Oxlumo (Eurasian)
Provider Order Form rev. 7/26/2024Patient Information
Patient Name:DOB:Patient Home Phone:Patient Cell Phone:Patient Email:Emergency/Alternate Contact Name:
NKDAEmergency/Alternate
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What is 53 primary hyperoxaluria?
53 primary hyperoxaluria is a rare genetic disorder that results in the overproduction of a substance called oxalate, leading to the formation of kidney stones and other complications.
Who is required to file 53 primary hyperoxaluria?
Medical professionals and researchers studying rare genetic disorders like primary hyperoxaluria are required to file reports on cases they encounter.
How to fill out 53 primary hyperoxaluria?
To fill out the 53 primary hyperoxaluria form, medical professionals must provide detailed information about the patient's medical history, symptoms, and test results.
What is the purpose of 53 primary hyperoxaluria?
The purpose of reporting 53 primary hyperoxaluria cases is to gather data for research and improve understanding and treatment of this rare genetic disorder.
What information must be reported on 53 primary hyperoxaluria?
Information such as patient demographics, medical history, symptoms, test results, and treatment plans must be reported on the 53 primary hyperoxaluria form.
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