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Number(s): 01-15-19, 02-15-16, 03-15-16, 08-15-19, 09-15-19, 11-15-16, 14-15-16, 24-15-17, 27-15-16, 30-15-16, 31-15-19, 32-15-16, 33-15-18
Issue Date: 06/25/2015
Effective Date: 07/20/2015
Subject: Prior Authorization of Contraceptives, Other - Pharmacy Service
Program Office(s): Office of Medical Assistance Programs
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