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Acetaminophen And Codeine Phosphate - Acetaminophen And Codeine Phosphate tablet
QCA Health Plan
QCA Health Plan Coverage for Acetaminophen And Codeine Phosphate - Acetaminophen And Codeine Phosphate tablet
All
3
Commercial
3
Commercial
Commercial - Other Insurer
No PA
No Step Therapy
Quantity Limit
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Commercial - Point of Service
No PA
No Step Therapy
Quantity Limit
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Commercial - PPO
No PA
No Step Therapy
Quantity Limit
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