Fidelis Care Authorization Grids Effective February 1, 2020
12/31/2019
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Posted by Provider Relations
The following section of the Fidelis Care authorization grids has been updated effective February 1, 2020.
The following service applies to Medicaid, Essential Plan, and Qualified Health Plans (Metal-Level Products) products and requires prior authorization:
IX. Pharmacy:
B. J0401 Aripiprazole ER inj (Abilify Maintena)
Visit: Authorization Grids