| Assigned number | Title | Release date | File type | Language | Available to order |
|---|---|---|---|---|---|
| F-11096A | Prior Authorization / Care Plan Attachment (PA/CPA): Completion Instructions | 09/01/2015 | English | No | |
| F-11096 | Prior Authorization / Care Plan Attachment (PA/CPA) | 08/01/2015 | English | No | |
| F-11096 | Prior Authorization / Care Plan Attachment (PA/CPA) | 08/01/2015 | Word | English | No |
Last revised July 13, 2025