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Prior Authorization/Preferred Drug List (PA/PDL) for Non-Preferred Stimulants

Assigned number Title Release date Language Available to order
F-01672A Prior Authorization/Preferred Drug List (PA/PDL) for Non-Preferred Stimulants, Instructions (PDF) 01/01/2022 English No
F-01672 Prior Authorization/Preferred Drug List (PA/PDL) for Non-Preferred Stimulants (PDF) 01/01/2017 English No
F-01672 Prior Authorization/Preferred Drug List (PA/PDL) for Non-Preferred Stimulants (Word) 01/01/2017 English No

Glossary

 
Last revised July 28, 2026