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Number(s): 01-17-46, 02-17-41, 03-17-41, 08-17-48, 09-17-45, 11-17-41, 14-17-42, 24-17-42, 27-17-43, 30-17-42, 31-17-47, 32-17-41, 33-17-46
Issue Date: 12/27/2017
Effective Date: 01/08/2018
Subject: Prior Authorization of Cytokine and CAM Antagonists - Pharmacy Services
Program Office(s): Office of Medical Assistance Programs
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