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Web tricare prior authorization request form for saxenda, wegovy, zepbound to be completed and signed by the prescriber. Web tricare prior authorization request form for liraglutide 3 mg injection (saxenda), semaglutide 2.4mg injection (wegovy) to. Web step please complete patient and physician information (please print): Search for your drug on the tricare formulary search tool; Web complete the wegovy™ savings.
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