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Dextroamphetamine SulfateĀ - Dextroamphetamine SulfateĀ tablet
Blue Cross Blue Shield Northern Plains Alliance (MCO)
Blue Cross Blue Shield Northern Plains Alliance (MCO) Coverage for Dextroamphetamine SulfateĀ - Dextroamphetamine SulfateĀ tablet
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Medicare - Prescription Drug Plan
No PA
No Step Therapy
Quantity Limit
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