Provider
P51-16 Addition of a Drug (Belviq XR) to the Weight Loss Agents Prior Authorization with Quantity Limit Program
Program effective Date: Oct 28, 2016
Program effective Date: Oct 28, 2016
Program effective Date: May 01, 2018
Program effective Date: May 25, 2017
Program effective Date: Nov 14, 2016
Program effective Date: May 02, 2017
Program effective Date: Nov 01, 2018
Program effective Date: Nov 01, 2017
Program effective Date: Oct 10, 2017
Program effective Date: Nov 28, 2016
Program effective Date: Feb 01, 2018