| Assigned number | Title | Release date | File type | Language | Available to order |
|---|---|---|---|---|---|
| F-11049A | Prior Authorization/Drug Attachment (PA/DGA), Instructions | 01/01/2024 | English | No | |
| F-11049 | Prior Authorization/Drug Attachment (PA/DGA) | 01/01/2024 | English | No | |
| F-11049 | Prior Authorization/Drug Attachment (PA/DGA) | 01/01/2024 | Word | English | No |
Last revised July 12, 2025