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Number(s): 01-16-05, 09-16-05, 27-16-05, 02-16-05, 11-16-05, 30-16-05, 03-16-05, 14-16-05, 31-16-05, 08-16-05, 24-16-05, 32-16-05, 33-16-05
Issue Date: 01/06/2016
Effective Date: 01/20/2016
Subject: Prior Authorization of Stimulants and Related Agents - Pharmacy Service
Program Office(s): Office of Medical Assistance Programs
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