Prior Authorization / Preferred Drug List (PA/PDL) for Migraine Agents, Injectable

Assigned Number	Title	Version Date	Publication Type	Other Location	Language
F-00622	Prior Authorization / Preferred Drug List (PA/PDL) for Migraine Agents, Injectable	June 1, 2012	PDF	None	English
F-00622	Prior Authorization/Preferred Drug List (PA/PDL) for Migraine Agents, Injectable Completion Instructions	July 1, 2015	PDF	None	English

Last Revised: July 1, 2020