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Number(s): 01-15-40, 09-15-38, 27-15-32, 02-15-32, 11-15-31, 30-15-31, 03-15-32, 14-15-33, 31-15-39, 08-15-38, 24-15-33, 32-15-32, 33-15-37
Issue Date: 11/30/2015
Effective Date: 12/01/2015
Subject: Prior Authorization of Orkambi (lumacaftor/ivacaftor)- Pharmacy Service
Program Office(s): Office of Medical Assistance Programs
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