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Pantoprazole Sodium i.V.- Pantoprazole Sodium injection, Powder, For Solution
District of Columbia (DC) FFS Program
District of Columbia (DC) FFS Program Coverage for Pantoprazole Sodium i.V.- Pantoprazole Sodium injection, Powder, For Solution
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2
State Medicaid
2
State Medicaid
State Medicaid - State Medicaid
No PA
No Step Therapy
No Quantity Limit
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State Medicaid - AIDS Drug Assistance Program
No PA
No Step Therapy
No Quantity Limit
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