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Ampicillin Sodium - Ampicillin Sodium injection, Powder, For Solution
Contra Costa Health Plan
Contra Costa Health Plan Coverage for Ampicillin Sodium - Ampicillin Sodium injection, Powder, For Solution
All
4
Commercial
2
Managed Medicaid
1
Medicare
1
Commercial
Commercial - HMO
PA Required
No Step Therapy
No Quantity Limit
See Details
Commercial - Employer
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
Medicare
Medicare - Medicare Advantage Part D
No PA
No Step Therapy
No Quantity Limit
See Details
Support for Getting Your Patient on Ampicillin Sodium - Ampicillin Sodium injection, Powder, For Solution
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Does Contra Costa Health Plan Cover Ampicillin? 4 Plans (2026)