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Periogard Alcohol Free - Chlorhexidine Gluconate rinse
Blue Shield of California (MCO)
Blue Shield of California (MCO) Coverage for Periogard Alcohol Free - Chlorhexidine Gluconate rinse
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8
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3
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3
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2
Commercial
Commercial - PPO
No PA
No Step Therapy
No Quantity Limit
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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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Health Exchange
Health Exchange - PPO - Health Insurance Exchange
No PA
No Step Therapy
No Quantity Limit
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Health Exchange - HMO - Health Insurance Exchange
No PA
No Step Therapy
No Quantity Limit
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Health Exchange - HDHP - Health Insurance Exchange
No PA
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
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