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Dextroamphetamine SulfateĀ - Dextroamphetamine SulfateĀ tablet
Memorial Hermann Health Insurance Company
Memorial Hermann Health Insurance Company Coverage for Dextroamphetamine SulfateĀ - Dextroamphetamine SulfateĀ tablet
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3
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2
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1
Commercial
Commercial - HMO
No PA
No Step Therapy
Quantity Limit
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Commercial - PPO
No PA
No Step Therapy
Quantity Limit
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Medicare
Medicare - Medicare Advantage Part D
No PA
No Step Therapy
Quantity Limit
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