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Amphetamine Sulfate - Amphetamine Sulfate tablet
WellDyneRx (MCO)
WellDyneRx (MCO) Coverage for Amphetamine Sulfate - Amphetamine Sulfate tablet
All
2
Commercial
2
Commercial
Commercial - Employer
No PA
Step Therapy
Quantity Limit
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Commercial - PBM Offering
No PA
Step Therapy
Quantity Limit
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