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Dextroamphetamine Sulfate - Dextroamphetamine Sulfate tablet
New Hampshire Healthy Families
New Hampshire Healthy Families Coverage for Dextroamphetamine Sulfate - Dextroamphetamine Sulfate tablet
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1
Managed Medicaid
1
Managed Medicaid
Managed Medicaid - HMO - Medicaid
No PA
No Step Therapy
No Quantity Limit
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