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Number(s): 01-17-14, 02-17-12, 03-17-12, 08-17-13, 09-17-13, 11-17-12, 14-17-12, 24-17-12, 27-17-12, 30-17-13, 31-17-14, 32-17-12, 33-17-13
Issue Date: 01/31/2017
Effective Date: 01/31/2017
Subject: Prior Authorization of Promacta (eltrombopag) - Pharmacy Services
Program Office(s): Office of Medical Assistance Programs
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