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Number(s): 01-16-04, 09-16-04, 27-16-04, 02-16-04, 11-16-04, 30-16-04, 03-16-04, 14-16-04, 31-16-04, 08-16-04, 24-16-04, 32-16-04, 33-16-04
Issue Date: 01/06/2016
Effective Date: 01/20/2016
Subject: Prior Authorization of Macular Degeneration Agents - Pharmacy Service
Program Office(s): Office of Medical Assistance Programs
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