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Xelstrym - Dextroamphetamine patch, Extended Release
Cook Children's Health Plan (CCHP)
Cook Children's Health Plan (CCHP) Coverage for Xelstrym - Dextroamphetamine patch, Extended Release
All
1
Managed Medicaid
1
Managed Medicaid
Managed Medicaid - HMO - Medicaid
PA Required
Step Therapy
No Quantity Limit
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Support for Getting Your Patient on Xelstrym - Dextroamphetamine patch, Extended Release
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