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Dextroamphetamine SulfateĀ - Dextroamphetamine SulfateĀ tablet
Blue California Promise Health Plan
Blue California Promise Health Plan Coverage for Dextroamphetamine SulfateĀ - Dextroamphetamine SulfateĀ tablet
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1
Managed Medicaid
1
Managed Medicaid
Managed Medicaid - HMO - Medicaid
No PA
No Step Therapy
Quantity Limit
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