For Workers' Compensation MSA or MCP:
- Medical records detailing the most recent 24 months of treatment.
- A claims payment history detailing medical payments made from the claim file in the most recent 24 months. The date printed should be visible on the document.
- A pharmacy (PBM) summary detailing prescriptions filled relative to the work injury the most recent 24 months. The summary should include the name, strength, prescriber and # of units dispensed.
- Include First Report of Injury if available