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Icosapent Ethyl - Icosapent Ethyl capsule
Blue California Promise Health Plan
Blue California Promise Health Plan Coverage for Icosapent Ethyl - Icosapent Ethyl capsule
All
1
Managed Medicaid
1
Managed Medicaid
Managed Medicaid - HMO - Medicaid
PA Required
No Step Therapy
No Quantity Limit
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