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This version of the form is not currently in use and is provided for reference only. Download this version of
Form FA-73
for the current year.
Form FA-73 Prior Authorization Request Nevada Medicaid - Optumrx - Suboxone and Subutex - Nevada
What Is Form FA-73?
This is a legal form that was released by the Nevada Department of Health and Human Services - a government authority operating within Nevada. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form FA-73?
A: Form FA-73 is a Prior Authorization Request form for Nevada Medicaid.
Q: Who is Optumrx?
A: Optumrx is a pharmacy benefit management company.
Q: What are Suboxone and Subutex?
A: Suboxone and Subutex are medications used in the treatment of opioid dependence.
Q: Why do I need prior authorization for Suboxone and Subutex?
A: Prior authorization is required by Nevada Medicaid to ensure appropriate use and coverage of medications.
Q: How do I submit Form FA-73?
A: Please follow the instructions on the form for submission, including any required documentation.
Form Details:
- Released on November 19, 2013;
- The latest edition provided by the Nevada Department of Health and Human Services;
- 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 FA-73 by clicking the link below or browse more documents and templates provided by the Nevada Department of Health and Human Services.
