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BUREAU FOR MEDICAL SERVICES EFFECTIVE WEST VIRGINIA ...

This is not an all-inclusive list of available covered drugs and includes only managed categories. Refer to cover page for complete list of rules governing this PDL. B2 EFFECTIVE 01/01/2022 Version 2022.1b • Prior authorization for a non-preferred agent in any class will be given only if there has been a trial of the preferred brand/generic

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