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Dextroamphetamine Sulfate - Dextroamphetamine Sulfate tablet
Mountain Health CO-OP (MCO)
Mountain Health CO-OP (MCO) Coverage for Dextroamphetamine Sulfate - Dextroamphetamine Sulfate tablet
All
4
Commercial
1
Health Exchange
3
Commercial
Commercial - PPO
No PA
No Step Therapy
Quantity Limit
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Health Exchange
Health Exchange - PPO - Health Insurance Exchange
No PA
No Step Therapy
Quantity Limit
See Details
Health Exchange - POS - Health Insurance Exchange
No PA
No Step Therapy
Quantity Limit
See Details
Health Exchange - HDHP - Health Insurance Exchange
No PA
No Step Therapy
Quantity Limit
See Details
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