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Gonal - F - Follitropin Alfa
State of California (MCO)
State of California (MCO) Coverage for Gonal - F - Follitropin Alfa
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4
Commercial
2
State Medicaid
2
Commercial
Commercial - Other Insurer
PA Required
No Step Therapy
No Quantity Limit
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Commercial - HMO
PA Required
No Step Therapy
No Quantity Limit
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State Medicaid
State Medicaid - State Medicaid
PA Required
No Step Therapy
No Quantity Limit
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State Medicaid - AIDS Drug Assistance Program
No PA
No Step Therapy
No Quantity Limit
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