| Assigned number | Title | Release date Sort ascending | Language | Available to order |
|---|---|---|---|---|
| F-11030A | Prior Authorization / Durable Medical Equipment Attachment (PA/DMEA) Instructions (PDF) | 02/15/2024 | English | No |
| F-11030 | Prior Authorization / Durable Medical Equipment Attachment (PA/DMEA) (Word) | 02/15/2024 | English | No |
| F-11030 | Prior Authorization / Durable Medical Equipment Attachment (PA/DMEA) (PDF) | 02/15/2024 | English | No |
Last revised June 30, 2026