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Promethazine Hydrochloride - Promethazine Hydrochloride syrup
Highmark Blue Shield
Highmark Blue Shield Coverage for Promethazine Hydrochloride - Promethazine Hydrochloride syrup
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2
Commercial
2
Commercial
Commercial - PPO
No PA
No Step Therapy
Quantity Limit
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Commercial - HMO
No PA
No Step Therapy
Quantity Limit
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