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Spritam - Levetiracetam tablet, For Suspension
Horizon Blue Cross and Blue Shield of New Jersey
Horizon Blue Cross and Blue Shield of New Jersey Coverage for Spritam - Levetiracetam tablet, For Suspension
All
7
Commercial
4
Health Exchange
1
Medicare
2
Commercial
Commercial - HMO
PA Required
Step Therapy
Quantity Limit
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Commercial - PPO
PA Required
Step Therapy
Quantity Limit
See Details
Commercial - Point of Service
PA Required
Step Therapy
Quantity Limit
See Details
Commercial - Employer
No PA
No Step Therapy
No Quantity Limit
See Details
Health Exchange
Health Exchange - PPO - Health Insurance Exchange
PA Required
Step Therapy
Quantity Limit
See Details
Medicare
Medicare - Medicare Advantage Part D
No PA
No Step Therapy
No Quantity Limit
See Details
Medicare - Prescription Drug Plan
No PA
No Step Therapy
No Quantity Limit
See Details
Support for Getting Your Patient on Spritam - Levetiracetam tablet, For Suspension
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