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Astagraf XL
Valley Health Plan (VHP) (MCO)
Valley Health Plan (VHP) (MCO) Coverage for Astagraf XL
All
2
Commercial
1
Health Exchange
1
Commercial
Commercial - Employer
PA Required
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
See Details
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