Assigned number | Title | Release date | File type | Language | Available to order |
---|---|---|---|---|---|
F-00433 | Prior Authorization/Preferred Drug List (PA/PDL) for Proton Pump Inhibitor (PPI) Orally Disintegrating Tablets | 07/01/2022 | English | No | |
F-00433A | Prior Authorization/Preferred Drug List (PA/PDL) for Proton Pump Inhibitor (PPI) Orally Disintegrating Tablets Instructions | 07/01/2022 | English | No | |
F-00433 | Prior Authorization/Preferred Drug List (PA/PDL) for Proton Pump Inhibitor (PPI) Orally Disintegrating Tablets | 07/01/2022 | Word | English | No |
Last revised July 13, 2025