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Amantadine Hydrochloride - Amantadine Hydrochloride capsule, Gelatin Coated
Community Care Plan (MCO)
Community Care Plan (MCO) Coverage for Amantadine Hydrochloride - Amantadine Hydrochloride capsule, Gelatin Coated
All
1
Managed Medicaid
1
Managed Medicaid
Managed Medicaid - HMO - Medicaid
No PA
No Step Therapy
Quantity Limit
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