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Acyclovir - Acyclovir ointment
Physicians Health Plan of Northern Indiana
Physicians Health Plan of Northern Indiana Coverage for Acyclovir - Acyclovir ointment
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2
Commercial
2
Commercial
Commercial - HMO
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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Does Physicians Health Plan of Northern Indiana Cover Acyclovir? 2 Plans (2026)