Atypical Antipsychot​ics for Children Prior Authorization form

Bureau for Medical Services

This government document is issued by Bureau for Medical Services for use in West Virginia

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File Details: PDF (1.27 MB)
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Source
https://dhhr.wv.gov/bms/BMS%20Pharmacy/Documents/Drug%20PA%20Criteria/Atypical%20Antipsychotics%20Children%20PaForm_2023.pdf

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