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Diclofenac Sodium - Diclofenac Sodium solution
Highmark Blue Cross Blue Shield of Western New York
Highmark Blue Cross Blue Shield of Western New York Coverage for Diclofenac Sodium - Diclofenac Sodium solution
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9
Commercial
4
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2
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1
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2
Commercial
Commercial - HMO
No PA
No Step Therapy
Quantity Limit
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Commercial - PPO
No PA
No Step Therapy
Quantity Limit
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Commercial - Point of Service
No PA
No Step Therapy
Quantity Limit
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Commercial - Employer
No PA
No Step Therapy
Quantity Limit
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Health Exchange
Health Exchange - POS - Health Insurance Exchange
No PA
No Step Therapy
No Quantity Limit
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Health Exchange - HMO - Health Insurance Exchange
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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Medicare
Medicare - Prescription Drug Plan
No PA
No Step Therapy
Quantity Limit
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Medicare - Medicare Advantage Part D
No PA
No Step Therapy
Quantity Limit
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