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Tolvaptan - TolvaptanĀ tablet
Group Health Cooperative of South Central Wisconsin (MCO)
Group Health Cooperative of South Central Wisconsin (MCO) Coverage for Tolvaptan - TolvaptanĀ tablet
All
6
Commercial
4
Health Exchange
1
Managed Medicaid
1
Commercial
Commercial - HMO
PA Required
No Step Therapy
Quantity Limit
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Commercial - PPO
PA Required
No Step Therapy
Quantity Limit
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Commercial - Point of Service
PA Required
No Step Therapy
Quantity Limit
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Commercial - Other Insurer
PA Required
No Step Therapy
Quantity Limit
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Health Exchange
Health Exchange - HMO - Health Insurance Exchange
PA Required
No Step Therapy
No Quantity Limit
See Details
Managed Medicaid
Managed Medicaid - HMO - Medicaid
No PA
No Step Therapy
No Quantity Limit
See Details
Support for Getting Your Patient on Tolvaptan - TolvaptanĀ tablet
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