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RAPAM.12 Form # 20910 R: 12.13 State of Maine Department of Health & Human Services MaineCare/MEDEL Prior Authorization Form
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Document Date: 2014-01-16 12:07:13

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File Size: 31,50 KB

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IndustryTerm

psoriasis therapies / psoriasis treatment / /

MedicalCondition

psoriasis / systemic psoriasis / /

MedicalTreatment

Phototherapy / /

Organization

Department of Health / /

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Product

Enbrel / Humira / Amevive / cyclosporine / methoxsalen / /

URL

www.mainecarepdl.org_ / /

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