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Number(s): 01-15-36, 02-15-28, 03-15-28, 08-15-34, 09-15-34, 11-15-27, 14-15-29, 24-15-29, 27-15-28, 30-15-27, 31-15-35, 32-15-28, 33-15-33
Issue Date: 11/13/2015
Effective Date: 10/26/2015
Subject: Prior Authorization of Antibiotics, GI - Pharmacy Service
Program Office(s): Office of Medical Assistance Programs
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