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Formoterol Fumarate - Formoterol Fumarate Dihydrate solution
Samaritan Health Plans
Samaritan Health Plans Coverage for Formoterol Fumarate - Formoterol Fumarate Dihydrate solution
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3
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2
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1
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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Medicare
Medicare - Medicare Advantage Part D
PA Required
No Step Therapy
Quantity Limit
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