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Number(s): 01-17-27, 02-17-25, 03-17-25, 08-17-28, 09-17-26, 11-17-25, 14-17-25, 24-17-25, 27-17-25, 30-17-26, 31-17-27, 32-17-25, 33-17-26
Issue Date: 06/07/2017
Effective Date: 06/06/2017
Subject: Prior Authorization of Spinraza (nusinersen) – Pharmacy Services
Program Office(s): Office of Medical Assistance Programs
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