4/29/2026
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Posted by Provider Relations
The following section of the Fidelis Care authorization grids has been updated effective June 1, 2026.
The following code has updated been on the Medicaid, CHP, Essential Plan, and Ambetter Metal-Level Plans Authorization Grids and requires prior authorization:
Q5111 pegfilgrastim-cbqv (udenyca)
Visit: Authorization Grids