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Number(s): 01-15-17, 02-15-14, 03-15-14, 08-15-17, 09-15-17, 11-15-14, 14-15-14, 24-15-15, 27-15-14, 30-15-14, 31-15-17, 32-15-14, 33-15-16
Issue Date: 06/22/2015
Effective Date: 07/20/2015
Subject: Prior Authorization of Antifungals, Topical – Pharmacy Service
Program Office(s): Office of Medical Assistance Programs
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