Provider
QP34-18 Pharmacy Benefit Update - New Drug-Related Prior Authorization (PA) with Quantity Limit (QL) Criteria: Uric Acid Transport 1 (URAT1) Inhibitor
Program effective Date: May 15, 2018
Program effective Date: May 15, 2018
Program effective Date: May 31, 2016
Program effective Date: Dec 03, 2018