Prior Authorization/Preferred Drug List (PA/PDL) for Non-Preferred Stimulants

Assigned Number Titlesort descending Version Date Publication Type Other Location Language
F-01672 Prior Authorization/Preferred Drug List (PA/PDL) for Non-Preferred Stimulants January 1, 2017
Word
English
F-01672 Prior Authorization/Preferred Drug List (PA/PDL) for Non-Preferred Stimulants January 1, 2017
PDF
English
F-01672 Prior Authorization/Preferred Drug List (PA/PDL) for Non-Preferred Stimulants Completion Instructions January 1, 2017
PDF
English
Last Revised: February 14, 2018