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Referral Forms Kroger Specialty Pharmacy

Referral Forms Kroger Specialty Pharmacy

Use a kroger specialty pharmacy forms 0 template to make your document workflow more streamlined.

PRESCRIPTION INFORMATION QUANTITY REFILLS o 162 mg o Autoinjector o PFS Vials o 80mg/4mL o 200mg/10mL Inject 162mg subcutaneously o ONCE a week or o every OTHER week o Infuse mg mg/kg every 4 weeks 4 Week Supply o Vials o 120mg o 400mg o Load Infuse mg 10 mg/kg at weeks 0 2 and 4 then every 4 weeks thereafter o Maintenance Infuse mg 10 mg/kg every 4 weeks Loading Dose None o o 200mg x2 PFS o 200mg x2 Vials o Starter Kit Inject 400mg subcutaneously at weeks 0 2 and 4 1 Starter Kit PFS /6 Vials o...
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