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Prior Authorization - Preferred Drug List (PA/PDL) for Cytokine and Cell Adhesion Molecule (CAM) Antagonist Drugs for Ulcerative Colitis

Assigned number Title Release date File type Language Available to order
F-00694A Prior Authorization / Preferred Drug List (PA/PDL) for Cytokine and Cell Adhesion Molecule (CAM) Antagonist Drugs for Ulcerative Colitis Completion Instructions 07/01/2015 PDF English No
F-00694 Prior Authorization - Preferred Drug List (PA/PDL) for Cytokine and Cell Adhesion Molecule (CAM) Antagonist Drugs for Ulcerative Colitis 12/01/2013 PDF English No

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Last revised February 23, 2026