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Number(s): 01-18-14, 02-18-09, 03-18-09, 08-18-16, 09-18-15, 11-18-09, 14-18-10, 24-18-10, 27-18-13, 30-18-09, 31-18-15, 32-18-09, 33-18-14
Issue Date: 07/23/2018
Effective Date: 07/23/2018
Subject: Prior Authorization of Lipotropics, Other – Pharmacy Services
Program Office(s): Office of Medical Assistance Programs
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