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Lisdexamfetamine Dimesylate - Lisdexamfetamine Dimesylate capsule
Highmark Blue Shield
Highmark Blue Shield Coverage for Lisdexamfetamine Dimesylate - Lisdexamfetamine Dimesylate capsule
All
2
Commercial
2
Commercial
Commercial - PPO
No PA
No Step Therapy
Quantity Limit
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Commercial - HMO
No PA
No Step Therapy
Quantity Limit
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