Prior Authorization Drug Attachment for Modafinil and Nuvigil®

Assigned Number Titlesort ascending Version Date Publication Type Other Location Language
F-00079 Prior Authorization Drug Attachment for Modafinil and Nuvigil® January 1, 2018
Word
English
F-00079 Prior Authorization Drug Attachment for Modafinil and Nuvigil® January 1, 2018
PDF
English
F-00079 Instructions January 1, 2018
PDF
English
Last Revised: January 3, 2018