Prior Authorization/Preferred Drug List (PA/PDL) for Growth Hormone Drugs

Assigned Number Titlesort descending Version Date Publication Type Other Location Language
F-11092 Effective for use before 07/01/2018: Prior Authorization/Preferred Drug List (PA/PDL) for Growth Hormone Drugs July 1, 2017
Word
English
F-11092 Effective for use before 07/01/2018: Prior Authorization/Preferred Drug List (PA/PDL) for Growth Hormone Drugs July 1, 2017
PDF
English
F-11092 Effective for use before 07/01/2018: Prior Authorization/Preferred Drug List (PA/PDL) for Growth Hormone Drugs Instructions July 1, 2017
PDF
English
F-11092 Effective for use on and after 07/01/2018: Prior Authorization/Preferred Drug List (PA/PDL) for Growth Hormone Drugs July 1, 2018
Word
English
F-11092 Effective for use on and after 07/01/2018: Prior Authorization/Preferred Drug List (PA/PDL) for Growth Hormone Drugs July 1, 2018
PDF
English
F-11092 Effective for use on and after 07/01/2018: Prior Authorization/Preferred Drug List (PA/PDL) for Growth Hormone Drugs Instructions July 1, 2018
PDF
English
Last Revised: June 15, 2018