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Memantine Hydrochloride - Memantine Hydrochloride Oral solution
Highmark Blue Cross Blue Shield
Highmark Blue Cross Blue Shield Coverage for Memantine Hydrochloride - Memantine Hydrochloride Oral solution
All
7
Commercial
3
Health Exchange
1
Managed Medicaid
1
Medicare
2
Commercial
Commercial - HMO
No PA
No Step Therapy
No Quantity Limit
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Commercial - Employer
No PA
No Step Therapy
No Quantity Limit
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Commercial - PPO
No PA
No Step Therapy
No Quantity Limit
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Health Exchange
Health Exchange - PPO - Health Insurance Exchange
No PA
No Step Therapy
No Quantity Limit
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Managed Medicaid
Managed Medicaid - HMO - Medicaid
PA Required
No Step Therapy
No Quantity Limit
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Medicare
Medicare - Medicare Advantage Part D
No PA
No Step Therapy
No Quantity Limit
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Medicare - Prescription Drug Plan
No PA
No Step Therapy
No Quantity Limit
See Details
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