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Number(s): 01-16-23, 09-16-21, 27-16-21, 02-16-20, 11-16-20, 30-16-20, 03-16-20, 14-16-21, 31-16-25, 08-16-21, 24-16-23, 32-16-19, 33-16-20
Issue Date: 07/05/2016
Effective Date: 07/11/2016
Subject: Prior Authorization of Incretin Mimetic/Enhancer Hypoglycemics - Pharmacy Services
Program Office(s): Office of Medical Assistance Programs
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