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Gocovri - Amantadine capsule, Coated Pellets
Indiana University Health Plans
Indiana University Health Plans Coverage for Gocovri - Amantadine capsule, Coated Pellets
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2
Commercial
2
Commercial
Commercial - PPO
PA Required
No Step Therapy
No Quantity Limit
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Commercial - HMO
PA Required
No Step Therapy
No Quantity Limit
See Details
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