Anthem

Zip Code. Office Phone Number ( ) - Office Fax Number ( ) - Office Contact Name. Physician Specialty . MEDICATION INFORMATION – This section serves as the active prescription – signature required. Drug Name. Zometa (4mg/5mL vial) Reclast (5mg/100mL bottle) HCPCS or CPT Code(s) J3487 . J3488 Strength / Dose . Direction for Use (SIG) ................
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