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Diclofenac Epolamine - Diclofenac Epolamine system
QCA Health Plan
QCA Health Plan Coverage for Diclofenac Epolamine - Diclofenac Epolamine system
All
3
Commercial
3
Commercial
Commercial - Other Insurer
PA Required
No Step Therapy
Quantity Limit
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Commercial - Point of Service
PA Required
No Step Therapy
Quantity Limit
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Commercial - PPO
PA Required
No Step Therapy
Quantity Limit
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