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Gavilyte G tm - Polyethylene Glycol-3350 And Electrolytes powder, For Solution
Capital District Physicians' Health Plan (CDPHP)
Capital District Physicians' Health Plan (CDPHP) Coverage for Gavilyte G tm - Polyethylene Glycol-3350 And Electrolytes powder, For Solution
All
6
Commercial
2
Health Exchange
2
Managed Medicaid
1
Medicare
1
Commercial
Commercial - HMO
No PA
No Step Therapy
No Quantity Limit
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Commercial - PPO
No PA
No Step Therapy
No Quantity Limit
See Details
Health Exchange
Health Exchange - HMO - Health Insurance Exchange
No PA
No Step Therapy
No Quantity Limit
See Details
Health Exchange - HDHP - Health Insurance Exchange
No PA
No Step Therapy
No Quantity Limit
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Managed Medicaid
Managed Medicaid - HMO - Medicaid
PA Required
No Step Therapy
No Quantity Limit
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Medicare
Medicare - Medicare Advantage Part D
No PA
No Step Therapy
No Quantity Limit
See Details
Support for Getting Your Patient on Gavilyte G tm - Polyethylene Glycol-3350 And Electrolytes powder, For Solution
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