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Prior authorization appeal tool


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Step {{index + 1}} of {{steps.length}}

Alternative treatment drug options

For step therapy protocols, select drug/treatment the insurance company is requiring you to prescribe your patient as an alternative treatment (skip if not applicable).

I have previously prescribed this patient the following therapies (optional):
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Prescribed from {{ convertDatePickerDate(medication.startDate) }} to {{ convertDatePickerDate(medication.endDate) }}

Reasoning: {{ medication.stopReason }}

Dates prescribed
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