Prior Authorization/Preferred Drug List (PA/PDL) for Glucagon-Like Peptide (GLP-1) Agents

Assigned Number	Title	Version Date	Publication Type	Other Location	Language
F-00238	Prior Authorization Drug Attachment for Glucagon-Like Peptide (GLP-1) Agents	July 1, 2020	PDF	None	English
F-00238	Prior Authorization Drug Attachment for Glucagon-Like Peptide (GLP-1) Agents	July 1, 2020	Word	None	English
F-00238	Prior Authorization Drug Attachment for Glucagon-Like Peptide (GLP-1) Agents Instructions	July 1, 2020	PDF	None	English

Last Revised: July 1, 2020