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

Assigned number Title Release date Language Available to order
F-00239A Prior Authorization / Drug Attachment for Blood Glucose Meters and Test Strips Completion Instructions (PDF) 07/01/2015 English No
F-00239 Prior Authorization / Drug Attachment for Blood Glucose Meters and Test Strips (PDF) 12/01/2013 English No
F-00239 Prior Authorization / Drug Attachment for Blood Glucose Meters and Test Strips (Word) 12/01/2013 English No

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Last revised July 31, 2026