For other uses, see Dominic (disambiguation). Dominic is a name common among Roman Catholics and other Latin-Romans as a boys name. Originally from the late Roman-Italic name Dominicus its translation means Of Our Lord, Lordly, Belonging to God or of the Master.
ï· Call us at 1-888-693-3211. ï· Fax an eviCore healthcare request form (available online) to 1-888-693-3210. Also, to ease the administrative burden of requiring prior authorization of OB Ultrasound studies, providers may batch service requests for up to 12 weeks and cases may be reviewed retrospectively for.
Â©2015 AbbVie Patient Assistance Foundation A-APP1-15J-1 Page 1 Application For AndroGelÂ® (testosterone gel) 1.62% AbbVie Patient Assistance Foundation â¢ P.O. Box 270 Somerville, NJ 08876 â¢ Phone: 1-800-222-6885 â¢ FAX: 1-800-276-9901 Please fax this form to 1-800-276-9901 or mail to address above HEALTHCARE PROVIDER INFORMATION