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Diclofenac Potassium - Diclofenac Potassium capsule, Liquid Filled
Highmark Blue Shield of Northeastern New York
Highmark Blue Shield of Northeastern New York Coverage for Diclofenac Potassium - Diclofenac Potassium capsule, Liquid Filled
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6
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4
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1
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1
Commercial
Commercial - HMO
PA Required
Step Therapy
Quantity Limit
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Commercial - PPO
PA Required
Step Therapy
Quantity Limit
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Commercial - Point of Service
PA Required
Step Therapy
Quantity Limit
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Commercial - Employer
PA Required
Step Therapy
Quantity Limit
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Health Exchange
Health Exchange - POS - Health Insurance Exchange
No PA
No Step Therapy
No Quantity Limit
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Medicare
Medicare - Medicare Advantage Part D
No PA
No Step Therapy
No Quantity Limit
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