Prior Authorization/Preferred Drug List (PA/PDL) for Orexin Receptor Antagonists

Assigned Number Title Sort descending Release Date File Type Language Available to Order
F-01673 Prior Authorization/Preferred Drug List (PA/PDL) for Orexin Receptor Antagonists 04/01/2022 PDF English
F-01673 Prior Authorization/Preferred Drug List (PA/PDL) for Orexin Receptor Antagonists 04/01/2022 Word English
F-01673A Prior Authorization/Preferred Drug List (PA/PDL) for Orexin Receptor Antagonists, Instructions 04/01/2022 PDF English

Glossary

 
Last revised September 19, 2024