All *ANTIPSYCHOTICS/ANTIMANIC AGENTS*

Abilify Maintena Prefilled Syringe 300 MG Intramuscular
Abilify Maintena Prefilled Syringe 300 MG Intramuscular

ARIPiprazole ER

Tier: 2
PA Type: No Prior Authorization
ST: Y
Abilify Maintena Prefilled Syringe 400 MG Intramuscular
Abilify Maintena Prefilled Syringe 400 MG Intramuscular

ARIPiprazole ER

Tier: 2
PA Type: No Prior Authorization
ST: Y
Abilify Maintena Suspension Reconstituted ER 300 MG Intramuscular
Abilify Maintena Suspension Reconstituted ER 300 MG Intramuscular

ARIPiprazole ER

Tier: 2
PA Type: No Prior Authorization
ST: Y
Abilify Maintena Suspension Reconstituted ER 300 MG Intramuscular
Abilify Maintena Suspension Reconstituted ER 300 MG Intramuscular

ARIPiprazole ER

Tier: 2
PA Type: No Prior Authorization
ST: Y
Abilify Maintena Suspension Reconstituted ER 400 MG Intramuscular
Abilify Maintena Suspension Reconstituted ER 400 MG Intramuscular

ARIPiprazole ER

Tier: 2
PA Type: No Prior Authorization
ST: Y
Abilify Maintena Suspension Reconstituted ER 400 MG Intramuscular
Abilify Maintena Suspension Reconstituted ER 400 MG Intramuscular

ARIPiprazole ER

Tier: 2
PA Type: No Prior Authorization
ST: Y
Abilify MyCite Tablet 10 MG Oral
Abilify MyCite Tablet 10 MG Oral

ARIPiprazole (sensor)

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Abilify MyCite Tablet 15 MG Oral
Abilify MyCite Tablet 15 MG Oral

ARIPiprazole (sensor)

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Abilify MyCite Tablet 2 MG Oral
Abilify MyCite Tablet 2 MG Oral

ARIPiprazole (sensor)

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Abilify MyCite Tablet 20 MG Oral
Abilify MyCite Tablet 20 MG Oral

ARIPiprazole (sensor)

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Abilify MyCite Tablet 30 MG Oral
Abilify MyCite Tablet 30 MG Oral

ARIPiprazole (sensor)

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Abilify MyCite Tablet 5 MG Oral
Abilify MyCite Tablet 5 MG Oral

ARIPiprazole (sensor)

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N