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Form FA-175 Toradol (Ketorolac Tromethamine) Prior Authorization Request Form - Nevada
What Is Form FA-175?
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-175 Toradol?
A: The Form FA-175 Toradol is a prior authorization request form for Ketorolac Tromethamine in Nevada.
Q: What is Ketorolac Tromethamine?
A: Ketorolac Tromethamine is a medication used to relieve moderate to severe pain.
Q: What is the purpose of the Form FA-175 Toradol?
A: The purpose of the Form FA-175 Toradol is to request prior authorization for the use of Ketorolac Tromethamine.
Q: Who needs to fill out the Form FA-175 Toradol?
A: Healthcare providers who want to prescribe Ketorolac Tromethamine in Nevada need to fill out the form.
Form Details:
- Released on August 31, 2020;
- 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-175 by clicking the link below or browse more documents and templates provided by the Nevada Department of Health and Human Services.
