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Humira (Pediatric) (Age 18 Years Old) Prior Authorization Request Form - Vermont
Humira (Pediatric) (Age 18 Years Old) Prior Authorization Request Form is a legal document that was released by the Department of Vermont Health Access - a government authority operating within Vermont.
FAQ
Q: What is the purpose of the Humira (Pediatric) Prior Authorization Request Form?
A: The form is used to request prior authorization for Humira (Pediatric) medication in Vermont.
Q: Who is the form intended for?
A: The form is intended for individuals who are 18 years old or younger and need Humira medication.
Q: What is Humira (Pediatric) medication used for?
A: Humira (Pediatric) is used to treat certain conditions such as juvenile idiopathic arthritis, pediatric Crohn's disease, and pediatric plaque psoriasis.
Q: Why is prior authorization required for Humira (Pediatric)?
A: Prior authorization is required to ensure that the medication is being used appropriately and is medically necessary for the individual.
Form Details:
- Released on September 27, 2018;
- The latest edition currently provided by the Department of Vermont Health Access;
- Ready to use and print;
- Easy to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Department of Vermont Health Access.
