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Number(s): 01-18-25, 09-18-26, 27-18-25, 33-18-25, 02-18-20, 11-18-20, 30-18-20, 03-18-21, 14-18-21, 31-18-26, 08-18-28, 24-18-22, 32-18-20
Issue Date: 12/12/2018
Effective Date: 12/17/2018
Subject: Prior Authorization of Angiotensin Modulator Combinations – Pharmacy Services
Program Office(s): Office of Medical Assistance Programs
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