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Lisdexamfetamine Dimesylate - Lisdexamfetamine Dimesylate capsule
Blue Cross Blue Shield of Wyoming
Blue Cross Blue Shield of Wyoming Coverage for Lisdexamfetamine Dimesylate - Lisdexamfetamine Dimesylate capsule
All
3
Commercial
2
Health Exchange
1
Commercial
Commercial - PPO
No PA
No Step Therapy
Quantity Limit
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Commercial - Employer
No PA
No Step Therapy
Quantity Limit
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Health Exchange
Health Exchange - PPO - Health Insurance Exchange
No PA
No Step Therapy
Quantity Limit
See Details
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