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Number(s): 01-15-22, 02-15-19, 03-15-19, 08-15-22, 09-15-22, 11-15-19, 14-15-19, 24-15-20, 27-15-19, 30-15-19, 31-15-22, 32-15-19, 33-15-21
Issue Date: 06/25/2015
Effective Date: 07/20/2015
Subject: Prior Authorization of Hypoglycemics, SGLT2 Inhibitors – Pharmacy Service
Program Office(s): Office of Medical Assistance Programs
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