Prior Authorization / Preferred Drug List (PA/PDL) for Proton Pump Inhibitor (PPI) Orally Disintegrating Tablets

Assigned Number Titlesort descending Version Date Publication Type Other Location Language
F-00433 Completion Instructions July 1, 2015
PDF
English
F-00433 Prior Authorization / Preferred Drug List (PA/PDL) for Proton Pump Inhibitor (PPI) Orally Disintegrating Tablets July 1, 2013
Word
English
F-00433 Prior Authorization / Preferred Drug List (PA/PDL) for Proton Pump Inhibitor (PPI) Orally Disintegrating Tablets July 1, 2013
PDF
English
Last Revised: February 1, 2018