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| Patient Name: BOB PATIENT |
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Situation |
CHOICE PLUS NETWORK |
CHOICE PLUS NON-NETWORK |
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Vendor
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Coverage is through Caremark ● Call: 1-866-846-9349
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Coverage is through Caremark ● Call:1-866-846-9349 |
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Refer to vendor
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Refer to vendor
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Refer to vendor
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Refer to vendor
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