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Prevymis
Independent Care Health Plan (iCare)
Independent Care Health Plan (iCare) Coverage for Prevymis
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2
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1
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1
Managed Medicaid
Managed Medicaid - HMO - Medicaid
No PA
No Step Therapy
No Quantity Limit
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Medicare
Medicare - Medicare Advantage Part D
PA Required
No Step Therapy
Quantity Limit
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