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

Assigned Number Title Release Date File Type Language Available to Order
F-01673A Prior Authorization/Preferred Drug List (PA/PDL) for Orexin Receptor Antagonists, Instructions 04/01/2022 PDF English No
F-01673 Prior Authorization/Preferred Drug List (PA/PDL) for Orexin Receptor Antagonists 04/01/2022 PDF English No
F-01673 Prior Authorization/Preferred Drug List (PA/PDL) for Orexin Receptor Antagonists 04/01/2022 Word English No
Last revised April 19, 2024