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Photrexa Cross - Linking Kit - Riboflavin 5-Phosphate Ophthalmic
Cook Children's Health Plan (CCHP)
Cook Children's Health Plan (CCHP) Coverage for Photrexa Cross - Linking Kit - Riboflavin 5-Phosphate Ophthalmic
All
1
Managed Medicaid
1
Managed Medicaid
Managed Medicaid - HMO - Medicaid
No PA
No Step Therapy
No Quantity Limit
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