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Sample of appeal new treatment

Download Sample Letter of Medical Necessity—New Treatment

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Sample of appeal change to treatment

Download Sample Letter of Appeal—Change to Treatment

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Sample letter of medical necessity new treatment

Download Sample Letter of Appeal—New Treatment

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Sample letter of medical necessity change of treatment

Download Sample Letter of Medical Necessity—Change of Treatment

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References: 1. Data on file. Coverage Change-ESI. Novartis Pharmaceuticals Corp; East Hanover, NJ. May 2024. 2. Data on file. First-line Commercial Coverage. Novartis Pharmaceuticals Corp; East Hanover, NJ. October 2024. 3. Data on file. Program data. Novartis Pharmaceuticals Corp; East Hanover, NJ. November 2023.