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Number(s): 01-18-31, 02-18-26, 03-18-27, 08-18-34, 09-18-32, 11-18-26, 14-18-27, 24-18-28, 27-18-31, 30-18-26, 31-18-32, 32-18-26, 33-18-31
Issue Date: 12/13/2018
Effective Date: 12/17/2018
Subject: Prior Authorization of Hypoglycemics, SGLT2 Inhibitors – Pharmacy Services
Program Office(s): Office of Medical Assistance Programs
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