![307828147-florida-blue-prior-authorization-form-for-medication](https://cdn.cocodoc.com/cocodoc-form/png/307828147--florida-blue-prior-authorization-form-for-medication--x-01.png)
florida blue prior authorization form for medication
Prescription drug claim form directions: 1. complete and sign claim form below. use a separate form for each patient. 2. attach explanation of benefits (if applicable) and prescription receipts. 3. send completed form & pharmacy receipts to: prime...
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