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Number(s): 01-17-33, 02-17-28, 03-17-28, 08-17-34, 09-17-31, 11-17-28, 14-17-28, 24-17-29, 27-17-29, 30-17-29, 31-17-33, 32-17-28, 33-17-32
Issue Date: 08/08/2017
Effective Date: 08/08/2017
Subject: Prior Authorization of Intra-Articular Hyaluronates - Pharmacy Services
Program Office(s): Office of Medical Assistance Programs
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