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Levetiracetam - Levetiracetam In Sodium Chloride injection
Driscoll Children's Health Plan (MCO)
Driscoll Children's Health Plan (MCO) Coverage for Levetiracetam - Levetiracetam In Sodium Chloride injection
All
1
Managed Medicaid
1
Managed Medicaid
Managed Medicaid - HMO - Medicaid
No PA
No Step Therapy
No Quantity Limit
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