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Dalfampridine - Dalfampridine tablet, Extended Release
Sharp Health Plan
Sharp Health Plan Coverage for Dalfampridine - Dalfampridine tablet, Extended Release
All
7
Commercial
4
Health Exchange
2
Medicare
1
Commercial
Commercial - HMO
PA Required
No Step Therapy
Quantity Limit
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Commercial - Point of Service
PA Required
No Step Therapy
Quantity Limit
See Details
Commercial - PPO
PA Required
No Step Therapy
Quantity Limit
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Commercial - Other Insurer
PA Required
No Step Therapy
Quantity Limit
See Details
Health Exchange
Health Exchange - HMO - Health Insurance Exchange
PA Required
No Step Therapy
Quantity Limit
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Health Exchange - HDHP - Health Insurance Exchange
PA Required
No Step Therapy
Quantity Limit
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Medicare
Medicare - Medicare Advantage Part D
PA Required
No Step Therapy
Quantity Limit
See Details
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