Prior Authorization Drug Attachment for Modafinil and Nuvigil®

Assigned Number Titlesort descending Version Date Publication Type Other Location Language
F-00079 Completion Instructions (PDF, 33 KB) January 13, 2017
PDF
English
F-00079 Prior Authorization Drug Attachment for Modafinil and Nuvigil® January 13, 2017
Word
English
F-00079 Prior Authorization Drug Attachment for Modafinil and Nuvigil® (PDF, 603 KB) January 13, 2017
PDF
English
Last Revised: January 13, 2017