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Number(s): 01-16-10, 09-16-12, 27-16-10, 02-16-10, 11-16-10, 30-16-10, 03-16-10 14-16-10, 31-16-12, 08-16-10, 24-16-11, 32-16-10, 33-16-10
Issue Date: 03/14/2016
Effective Date: 03/14/2016
Subject: Prior Authorization of Lipotropics, Other - Pharmacy Service
Program Office(s): Office of Medical Assistance Programs
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