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Number(s): 01-18-36, 09-18-37, 27-18-36, 33-18-36, 02-18-31, 11-18-31, 30-18-31, 03-18-32, 14-18-32, 31-18-37, 08-18-39, 24-18-33, 32-18-31
Issue Date: 12/12/2018
Effective Date: 12/17/2018
Subject: Prior Authorization of Antibiotics, GI and Related Agents – Pharmacy Services
Program Office(s): Office of Medical Assistance Programs
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