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

Assigned number Title Release date Language Available to order
F-01673A Prior Authorization/Preferred Drug List (PA/PDL) for Orexin Receptor Antagonists, Instructions (PDF) 04/01/2022 English No
F-01673 Prior Authorization/Preferred Drug List (PA/PDL) for Orexin Receptor Antagonists (PDF) 04/01/2022 English No
F-01673 Prior Authorization/Preferred Drug List (PA/PDL) for Orexin Receptor Antagonists (Word) 04/01/2022 English No

Glossary

 
Last revised September 12, 2026