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Xiidra
OptumRx (MCO)
OptumRx (MCO) Coverage for Xiidra
All
3
Commercial
2
Medicare
1
Commercial
Commercial - Employer
PA Required
Step Therapy
Quantity Limit
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Commercial - PBM Offering
PA Required
Step Therapy
Quantity Limit
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Medicare
Medicare - Prescription Drug Plan
No PA
Step Therapy
Quantity Limit
See Details
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