Prior Authorization / Drug Attachment for Blood Glucose Meters and Test Strips

Assigned Number Titlesort descending Version Date Publication Type Other Location Language
F-00239 Completion Instructions (PDF, 27 KB) July 1, 2015
PDF
English
F-00239 Prior Authorization / Drug Attachment for Blood Glucose Meters and Test Strips December 1, 2013
Word
English
F-00239 Prior Authorization / Drug Attachment for Blood Glucose Meters and Test Strips (PDF, 1.3 MB) December 1, 2013
PDF
English
Last Revised: December 1, 2015