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Dalfampridine - Dalfampridine tablet, Extended Release
OptumRx (MCO)
OptumRx (MCO) Coverage for Dalfampridine - Dalfampridine tablet, Extended Release
All
3
Commercial
2
Medicare
1
Commercial
Commercial - Employer
PA Required
No Step Therapy
Quantity Limit
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Commercial - PBM Offering
PA Required
No Step Therapy
Quantity Limit
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Medicare
Medicare - Prescription Drug Plan
PA Required
No Step Therapy
Quantity Limit
See Details
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