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Acyclovir Sodium - Acyclovir Sodium injection, Solution
Hawaii Medical Service Association (HMSA)
Hawaii Medical Service Association (HMSA) Coverage for Acyclovir Sodium - Acyclovir Sodium injection, Solution
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8
Commercial
3
Health Exchange
2
Managed Medicaid
1
Medicare
2
Commercial
Commercial - HMO
No PA
No Step Therapy
No Quantity Limit
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Commercial - PPO
No PA
No Step Therapy
No Quantity Limit
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Commercial - Other Insurer
No PA
No Step Therapy
No Quantity Limit
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Health Exchange
Health Exchange - PPO - Health Insurance Exchange
No PA
No Step Therapy
No Quantity Limit
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Health Exchange - HDHP - Health Insurance Exchange
No PA
No Step Therapy
No Quantity Limit
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Managed Medicaid
Managed Medicaid - HMO - Medicaid
No PA
No Step Therapy
No Quantity Limit
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Medicare
Medicare - Medicare Advantage Part D
PA Required
No Step Therapy
No Quantity Limit
See Details
Medicare - Prescription Drug Plan
PA Required
No Step Therapy
No Quantity Limit
See Details
Support for Getting Your Patient on Acyclovir Sodium - Acyclovir Sodium injection, Solution
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