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Prior Authorization MERCY MARICOPA INTEGRATED CARE TXIX/XXI SMI MEDICAID SGLT2 Inhibitors Medicaid This fax machine is located in a secure location as required by HIPAA regulations. 4mg per dL for females or greater than 1. 5mg per dL for males B C7901-A / Effective Date 03/01/2017 Metabolic acidosis C Diabetic ketoacidosis Please list contraindication s If no then no further questions 5. Does the patient have any of the following contraindications to A Renal dysfunction serum creatinine...
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