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Hydroxychloroquine Sulfate - Hydroxychloroquine Sulfate tablet
Blue Cross and Blue Shield of Minnesota
Blue Cross and Blue Shield of Minnesota Coverage for Hydroxychloroquine Sulfate - Hydroxychloroquine Sulfate tablet
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5
Commercial
2
Health Exchange
1
Managed Medicaid
1
Medicare
1
Commercial
Commercial - PPO
No PA
No Step Therapy
No Quantity Limit
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Commercial - Employer
No PA
No Step Therapy
No Quantity Limit
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Health Exchange
Health Exchange - PPO - Health Insurance Exchange
No PA
No Step Therapy
No Quantity Limit
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Managed Medicaid
Managed Medicaid - HMO - Medicaid
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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