| Assigned Number |
Title |
Version Date | Publication Type | Other Location | Language |
|---|---|---|---|---|---|
| F-00556 | Instructions | January 1, 2018 |
PDF
|
None | English |
| F-00556 | Prior Authorization Drug Attachment for Antipsychotic Drugs for Children 8 Years of Age and Younger | January 1, 2018 |
Word
|
None | English |
| F-00556 | Prior Authorization Drug Attachment for Antipsychotic Drugs for Children 8 Years of Age and Younger | January 1, 2018 |
PDF
|
None | English |
Last Revised: August 1, 2019
