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Ormalvi - Dichlorphenamide tablet
Blue Cross and Blue Shield of Oklahoma
Blue Cross and Blue Shield of Oklahoma Coverage for Ormalvi - Dichlorphenamide tablet
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5
Commercial
3
Health Exchange
2
Commercial
Commercial - Employer
No PA
No Step Therapy
No Quantity Limit
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Commercial - PPO
No PA
No Step Therapy
No Quantity Limit
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Commercial - HMO
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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Health Exchange - HMO - Health Insurance Exchange
No PA
No Step Therapy
No Quantity Limit
See Details
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