2022 Plan Year
2022 Part B Drug Prior Authorization List
2022 Tribute Advantage Prior Authorization Form
2022 Tribute Advantage Prior Authorization and Referrals List
2022 Tribute Select Prior Authorization Form
2022 Tribute Select Prior Authorization and Referrals List
2021 Plan Year
2021 Prior Authorization and Referrals List
Provider MOC Training and Attestation
2020 Plan Year
2020 Prior Authorization and Referrals List
2020 Part B Drug Authorization List
2020 Clinical Practice Guidelines
Last Updated: