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Daraprim - Pyrimethamine tablet
First Medical Health Plan
First Medical Health Plan Coverage for Daraprim - Pyrimethamine tablet
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2
Commercial
1
Managed Medicaid
1
Commercial
Commercial - PPO
No PA
No Step Therapy
No Quantity Limit
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Managed Medicaid
Managed Medicaid - HMO - Medicaid
No PA
No Step Therapy
Quantity Limit
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Support for Getting Your Patient on Daraprim - Pyrimethamine tablet
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