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Number(s): 01-18-35, 02-18-30, 03-18-31, 08-18-38, 09-18-36, 11-18-30, 14-18-31, 24-18-32, 27-18-35, 30-18-30, 31-18-36, 32-18-30, 33-18-35
Issue Date: 12/13/2018
Effective Date: 12/17/2018
Subject: Prior Authorization of Orkambi (lumacaftor/ivacaftor) – Pharmacy Services
Program Office(s): Office of Medical Assistance Programs
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