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Polymyxin B Sulfate And Trimethoprim Sulfate - Polymyxin B Sulfate And Trimethoprim Sulfate solution/ Drops
AlohaCare (MCO)
AlohaCare (MCO) Coverage for Polymyxin B Sulfate And Trimethoprim Sulfate - Polymyxin B Sulfate And Trimethoprim Sulfate solution/ Drops
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2
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1
Medicare
1
Managed Medicaid
Managed Medicaid - HMO - Medicaid
No PA
No Step Therapy
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Medicare
Medicare - Medicare Advantage Part D
No PA
No Step Therapy
No Quantity Limit
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