Form FA-163 Daliresp Prior Authorization Request Form - Nevada

What Is Form FA-163?

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 the Form FA-163 Daliresp Prior Authorization Request Form?
A: The Form FA-163 Daliresp Prior Authorization Request Form is a form used in Nevada to request prior authorization for the medication Daliresp.

Q: What is Daliresp?
A: Daliresp is a medication used to reduce the risk of chronic obstructive pulmonary disease (COPD) exacerbations in patients with severe COPD.

Q: When is the Form FA-163 Daliresp Prior Authorization Request Form used?
A: The Form FA-163 Daliresp Prior Authorization Request Form is used when a healthcare provider wants to prescribe Daliresp to a patient and needs to get prior authorization from the patient's insurance company.

Q: Who needs to fill out the Form FA-163 Daliresp Prior Authorization Request Form?
A: The healthcare provider prescribing Daliresp needs to fill out the Form FA-163 Daliresp Prior Authorization Request Form.