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Form HCA13-852A Xolair (Omalizumab) J2357 Request - Washington
What Is Form HCA13-852A?
This is a legal form that was released by the Washington State Health Care Authority - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form HCA13-852A?A: Form HCA13-852A is a specific form used for requesting Xolair (Omalizumab) J2357 in Washington.
Q: What is Xolair (Omalizumab) J2357?A: Xolair (Omalizumab) J2357 is a medication used for the treatment of asthma and chronic idiopathic urticaria.
Q: Who can use Form HCA13-852A?A: Form HCA13-852A can be used by healthcare providers or patients in Washington who need to request Xolair (Omalizumab) J2357.
Q: How do I fill out Form HCA13-852A?A: To fill out Form HCA13-852A, provide the requested information about the patient, healthcare provider, and the specific request for Xolair (Omalizumab) J2357.
Q: Is there a cost for filling out Form HCA13-852A?A: There may be costs associated with the prescription and administration of Xolair (Omalizumab) J2357, but there is no specific cost for filling out the form itself.
Form Details:
- Released on March 1, 2012;
- The latest edition provided by the Washington State Health Care Authority;
- 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 HCA13-852A by clicking the link below or browse more documents and templates provided by the Washington State Health Care Authority.
