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Sx Pre - Op Prep Pouch - Mupirocin Ointment
Kaiser Foundation Health Plan of Washington
Kaiser Foundation Health Plan of Washington Coverage for Sx Pre - Op Prep Pouch - Mupirocin Ointment
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5
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4
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1
Commercial
Commercial - HMO
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 - Employer
No PA
No Step Therapy
No Quantity Limit
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Commercial - Other Insurer
No PA
No Step Therapy
No Quantity Limit
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Health Exchange
Health Exchange - HMO - Health Insurance Exchange
No PA
No Step Therapy
No Quantity Limit
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