Proton Pump Inhibitors < 6 Years of Age Form

Office of the Deputy Secretary for Administration

This government document is issued by Office of the Deputy Secretary for Administration for use in Pennsylvania

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File Details: PDF (137 KB)
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Source
https://www.dhs.pa.gov/providers/Pharmacy-Services/Documents/Fax%20Forms%20SW%20PDL/Proton%20Pump%20Inhibitors%20Less%20Than%206%20y.o.%20PEAP%20Form%2001-01-20.pdf

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