| Assigned Number | Title | Release Date Sort ascending | File Type | Language | Available to Order |
|---|---|---|---|---|---|
| F-02668 | Prior Authorization/Preferred Drug List (PA/PDL) for Headache Agents, Triptans Non-Injectable | 07/01/2020 | English | No | |
| F-02668A | Prior Authorization/Preferred Drug List (PA/PDL) for Headache Agents, Triptans Non-Injectable Instructions | 07/01/2020 | English | No | |
| F-02668 | Prior Authorization/Preferred Drug List (PA/PDL) for Headache Agents, Triptans Non-Injectable | 07/01/2020 | Word | English | No |
Last revised April 23, 2025