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Number(s): 01-18-29, 02-18-24, 03-18-25, 08-18-32, 09-18-30, 11-18-24, 14-18-25, 24-18-26, 27-18-29, 30-18-24, 31-18-30, 32-18-24, 33-18-29
Issue Date: 12/13/2018
Effective Date: 12/17/2018
Subject: Prior Authorization of Hypoglycemics, Incretin Mimetics/Enhancers – Pharmacy Services
Program Office(s): Office of Medical Assistance Programs
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