| Assigned number | Title | Release date Sort ascending | Language | Available to order |
|---|---|---|---|---|
| F-01749 | Prior Authorization Drug Attachment for Hypoglycemics, Insulins Long-Acting (PDF) | 07/01/2024 | English | No |
| F-01749A | Prior Authorization Drug Attachment for Hypoglycemics, Insulins Long-Acting Instructions (PDF) | 07/01/2024 | English | No |
| F-01749 | Prior Authorization Drug Attachment for Hypoglycemics, Insulins Long-Acting (Word) | 07/01/2024 | English | No |
Last revised October 12, 2026