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Amantadine Hydrochloride - Amantadine Hydrochloride capsule
Serve You Prescription Services (SPS) (MCO)
Serve You Prescription Services (SPS) (MCO) Coverage for Amantadine Hydrochloride - Amantadine Hydrochloride capsule
All
2
Commercial
2
Commercial
Commercial - PBM Offering
No PA
No Step Therapy
No Quantity Limit
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Commercial - Employer
No PA
No Step Therapy
No Quantity Limit
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