Common Contracts
1 similar Pharmacy Agreement contracts
DSB-0511 PHARMACY BILLING FORMPharmacy Agreement • April 17th, 2019
DSB-0511 is used by pharmacies that have signed a working agreement (DSB-4020: Pharmacy Agreement) with the Division of Services for the Blind to provide pharmaceutical services to consumers of the agency. These drugs include those authorized for individual consumers for diagnostic, palliative, or therapeutic purposes.
