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Periogard Alcohol Free - Chlorhexidine Gluconate rinse
Driscoll Children's Health Plan (MCO)
Driscoll Children's Health Plan (MCO) Coverage for Periogard Alcohol Free - Chlorhexidine Gluconate rinse
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Managed Medicaid
Managed Medicaid - HMO - Medicaid
No PA
No Step Therapy
No Quantity Limit
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