Professional Referral Helpline
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DETAILED WRITTEN ORDERS PRIOR TO DELIVERY (DWOPD)
- Beneficiary's name
- The date of the order
- Start date of the order (if different than the date of the order)
- Detailed description of the items (i.e. semi-electric hospital bed) to include:
- Dosage/concentration if applicable
- Route of administration if applicable
- Frequency of use if applicable
- Quantity to be dispensed if applicable
- Number of refills if applicable
- Physician signature and date
- Physician NPI
NOTE: Physician Notes must address the need of the equipment