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Polocaine - Mepivacaine Hydrochloride injection, Solution
QCA Health Plan
QCA Health Plan Coverage for Polocaine - Mepivacaine Hydrochloride injection, Solution
All
3
Commercial
3
Commercial
Commercial - Other Insurer
No PA
No Step Therapy
No Quantity Limit
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Commercial - Point of Service
No PA
No Step Therapy
No Quantity Limit
See Details
Commercial - PPO
No PA
No Step Therapy
No Quantity Limit
See Details
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Does QCA Health Plan Cover Polocaine? 3 Plans (2026)