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Number(s): 01-16-30, 09-16-28, 27-16-27, 02-16-26, 11-16-26, 30-16-26, 03-16-26, 14-16-27, 31-16-32, 08-16-28, 24-16-29, 32-16-25, 33-16-27
Issue Date: 09/30/2016
Effective Date: 10/03/2016
Subject: Prior Authorization of Incretin Mimetic/Enhancer Hypoglycemics - Pharmacy Services
Program Office(s): Office of Medical Assistance Programs
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