Form 1356 Xyrem Standard Prior Authorization Addendum (Fee-For-Service) - Texas

Form 1356 Xyrem Standard Prior Authorization Addendum (Fee-For-Service) - Texas

What Is Form 1356?

This is a legal form that was released by the Texas Health and Human Services - a government authority operating within Texas. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on October 1, 2022;
  • The latest edition provided by the Texas Health and Human Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form 1356 by clicking the link below or browse more documents and templates provided by the Texas Health and Human Services.

ADVERTISEMENT

Other Revision

Download Form 1356 Xyrem Standard Prior Authorization Addendum (Fee-For-Service) - Texas

4.8 of 5 (31 votes)
  • Form 1356 Xyrem Standard Prior Authorization Addendum (Fee-For-Service) - Texas, Page 1
ADVERTISEMENT