Prior Authorization / Drug Attachment for Anti-Obesity Drugs

Assigned Number Titlesort descending Version Date Publication Type Other Location Language
F-00163 Effective for use before 07/01/2021: Prior Authorization Drug Attachment for Anti-Obesity Drugs January 1, 2021
Word
English
F-00163 Effective for use before 07/01/2021: Prior Authorization Drug Attachment for Anti-Obesity Drugs January 1, 2021
PDF
English
F-00163 Effective for use before 07/01/2021: Prior Authorization Drug Attachment for Anti-Obesity Drugs, Instructions January 1, 2021
PDF
English
F-00163 Effective for use on and after 07/01/2021: Prior Authorization Drug Attachment for Anti-Obesity Drugs July 1, 2021
Word
English
F-00163 Effective for use on and after 07/01/2021: Prior Authorization Drug Attachment for Anti-Obesity Drugs July 1, 2021
PDF
English
F-00163 Effective for use on and after 07/01/2021: Prior Authorization Drug Attachment for Anti-Obesity Drugs, Instructions July 1, 2021
PDF
English
Last Revised: June 18, 2021