Assigned Number | Title | Release Date | File Type | Language | Available to Order |
---|---|---|---|---|---|
F-00622 | Prior Authorization / Preferred Drug List (PA/PDL) for Migraine Agents, Injectable | 06/01/2012 | English | No | |
F-00622A | Prior Authorization/Preferred Drug List (PA/PDL) for Migraine Agents, Injectable Completion Instructions | 07/01/2015 | English | No |
Last revised September 19, 2024