| Assigned Number | Title | Release Date Sort ascending | File Type | Language | Available to Order |
|---|---|---|---|---|---|
| F-11020A | Prior Authorization Request for Hearing Instrument and Audiological Services (PA/HIAS1) Completion Instructions | 02/01/2016 | English | No | |
| F-11020 | Prior Authorization Request for Hearing Instrument and Audiological Services (PA/HIAS1) | 05/01/2013 | English | No | |
| F-11020 | Prior Authorization Request for Hearing Instrument and Audiological Services (PA/HIAS1) | 05/01/2013 | Word | English | No |
Last revised June 30, 2025