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Get Anthem Predetermination

Request for Redetermination of Medicare Prescription Drug Denial Because we Anthem MediBlue Value HMO denied your request for coverage of or payment for a prescription drug you have the right to ask us for a redetermination appeal of our decision. You have 60 days from the date of our Notice of Denial of Medicare Prescription Drug Coverage to ask us for a redetermination. This form may be sent to us by mail or fax Address Fax Number 4361 Irwin Si.

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