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Web prior authorization is required before certain services are rendered to confirm medical necessity as defined by the member’s plan. Web 2022 prior authorization list; Fax completed form to the number above. Primary procedure code* (cpt/hcpcs) (modifier) additional procedure code.
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Web meridian prefered drug list (pdf) last updated 7/31/2023; Prior authorization, step therapy and quantity limits. To submit a prior authorization login here. Web illinois medicaid pharmacy prior authorization request form state of illinois department of healthcare and family services fax completed form to patient's health.
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