Prior Authorization/Preferred Drug List (PA/PDL) for Opioid Dependency Agents – Buprenorphine

Assigned Number	Title	Version Date	Publication Type	Other Location	Language
F-00081	Effective for use before 07/01/2018: Prior Authorization/Preferred Drug List (PA/PDL) for Opioid Dependency Agents – Buprenorphine	January 1, 2018	Word	None	English
F-00081	Effective for use before 07/01/2018: Prior Authorization/Preferred Drug List (PA/PDL) for Opioid Dependency Agents – Buprenorphine	January 1, 2018	PDF	None	English
F-00081	Effective for use before 07/01/2018: Prior Authorization/Preferred Drug List (PA/PDL) for Opioid Dependency Agents – Buprenorphine Instructions	January 1, 2018	PDF	None	English
F-00081	Effective for use on and after 07/01/2018: Prior Authorization/Preferred Drug List (PA/PDL) for Opioid Dependency Agents – Buprenorphine	July 1, 2018	Word	None	English
F-00081	Effective for use on and after 07/01/2018: Prior Authorization/Preferred Drug List (PA/PDL) for Opioid Dependency Agents – Buprenorphine	July 1, 2018	PDF	None	English
F-00081	Effective for use on and after 07/01/2018: Prior Authorization/Preferred Drug List (PA/PDL) for Opioid Dependency Agents – Buprenorphine Instructions	July 1, 2018	PDF	None	English

Last Revised: June 15, 2018