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Acetic Acid - Acetic Acid irrigant
ITASCA Medical Care (MCO)
ITASCA Medical Care (MCO) Coverage for Acetic Acid - Acetic Acid irrigant
All
1
Managed Medicaid
1
Managed Medicaid
Managed Medicaid - HMO - Medicaid
No PA
No Step Therapy
No Quantity Limit
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