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CA-27, Authorization Request form and Certification/Letter of Medical Necessity for Opioid Medications

ICR 202404-1240-005 · OMB 1240-0055 · Object 142011501.

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application/octet-stream
CA-27, Authorization Request form and Certification/Letter of Medical Necessity for Opioid Medications
2017-05-12
2016-10-11
complete