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Number(s): 01-17-21, 02-17-19, 03-17-19, 08-17-21, 09-17-20, 11-17-19, 14-17-19, 24-17-19, 27-17-19, 30-17-20, 31-17-21, 32-17-19, 33-17-20
Issue Date: 04/27/2017
Effective Date: 05/01/2017
Subject: Prior Authorization of Cytokine and CAM Antagonists – Pharmacy Services
Program Office(s): Office of Medical Assistance Programs
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