Skip to main content

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

Assigned Number Title Release Date File Type Language Available to Order
F-01672A Prior Authorization/Preferred Drug List (PA/PDL) for Non-Preferred Stimulants, Instructions 01/01/2022 PDF English No
F-01672 Prior Authorization/Preferred Drug List (PA/PDL) for Non-Preferred Stimulants 01/01/2017 PDF English No
F-01672 Prior Authorization/Preferred Drug List (PA/PDL) for Non-Preferred Stimulants 01/01/2017 Word English No

Glossary

 
Last revised September 25, 2024