Xarelto Migraines

Medical History (Last, First) - Distinctively Dental
Medical History Patient Name (Last, First) Y N Clotting / Bleeding Problems / Vascular Problems Y N Frequent Headaches / Migraines Y N Anemia Y N BLOOD THINNERS other than aspirin? Coumadin/Warfarin; Plavix; Pradaxa, Xarelto, Eliquis; Cancer Medication: ... Return Doc

Table 1: QUEST New Preauthorization Effective September 1, 2013
Table 1: QUEST – New Preauthorization – Effective September 1, 2013 Medication Category Medication Utilization Management Type Rationale/Criteria ... Document Retrieval

Medical History Form.APAS.Oct2014 - Njplasticsurgerygroup.com
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