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Ampicillin - Ampicillin capsule
Community Health Plan of Washington (CHPW)
Community Health Plan of Washington (CHPW) Coverage for Ampicillin - Ampicillin capsule
All
3
Health Exchange
1
Managed Medicaid
1
Medicare
1
Health Exchange
Health Exchange - PPO - Health Insurance Exchange
PA Required
No Step Therapy
No Quantity Limit
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Managed Medicaid
Managed Medicaid - HMO - Medicaid
PA Required
No Step Therapy
No Quantity Limit
See Details
Medicare
Medicare - Medicare Advantage Part D
No PA
No Step Therapy
No Quantity Limit
See Details
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