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NC Medicaid and NC Health Choice Pharmacy Prior Approval Request for GLP1 Receptor Agonists and Combinations Beneficiary Information 1. Beneficiary Last Name: ___ 2. First Name: ___ 3. Beneficiary

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People with type 2 diabetes who have not achieved adequate blood sugar control with other medications or lifestyle changes.

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What is glp-1 receptor agonists?

GLP-1 receptor agonists are a type of medication used to treat type 2 diabetes by mimicking the effects of the hormone GLP-1.

Who is required to file glp-1 receptor agonists?

Healthcare providers are required to prescribe and administer GLP-1 receptor agonists to patients.

How to fill out glp-1 receptor agonists?

GLP-1 receptor agonists can be administered via injection or oral medication as prescribed by a healthcare provider.

What is the purpose of glp-1 receptor agonists?

The purpose of GLP-1 receptor agonists is to help lower blood sugar levels and improve blood glucose control in patients with type 2 diabetes.

What information must be reported on glp-1 receptor agonists?

Information such as dosage, frequency of administration, side effects, and patient response must be reported by healthcare providers.

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