| Assigned number | Title | Release date Sort ascending | File type | Language | Available to order |
|---|---|---|---|---|---|
| F-11051 | Prior Authorization / Vision Services Attachment (PA/VA) | 10/09/2020 | English | No | |
| F-11051A | Prior Authorization / Vision Services Attachment (PA/VA), Instructions | 10/09/2020 | English | No | |
| F-11051 | Prior Authorization / Vision Services Attachment (PA/VA) | 10/09/2020 | Word | English | No |
Last revised July 16, 2025