Form FA-160 Elidel (Pimecrolimus) Prior Authorization Request Form - Nevada

Form FA-160 Elidel (Pimecrolimus) Prior Authorization Request Form - Nevada

What Is Form FA-160?

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-160?
A: Form FA-160 is the Elidel (Pimecrolimus) Prior Authorization Request Form in Nevada.

Q: What is Elidel (Pimecrolimus)?
A: Elidel (Pimecrolimus) is a medication used to treat eczema.

Q: What is a prior authorization request form?
A: A prior authorization request form is a document that needs to be filled out by a healthcare provider to determine if a medication will be covered by insurance.

Q: Why is a prior authorization request necessary?
A: A prior authorization request is necessary to ensure that medications are being used appropriately and to help control healthcare costs.

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Form Details:

  • Released on July 1, 2019;
  • 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 printable version of Form FA-160 by clicking the link below or browse more documents and templates provided by the Nevada Department of Health and Human Services.

Download Form FA-160 Elidel (Pimecrolimus) Prior Authorization Request Form - Nevada

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