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North American Coral Snake Antivenin (Equine)- Coral Snake (Micrurus Fulvius) Immune Globulin Antivenin (Equine) injection, Powder, For Solution
The Health Plan (of the Upper Ohio Valley)
The Health Plan (of the Upper Ohio Valley) Coverage for North American Coral Snake Antivenin (Equine)- Coral Snake (Micrurus Fulvius) Immune Globulin Antivenin (Equine) injection, Powder, For Solution
All
5
Commercial
3
Managed Medicaid
1
Medicare
1
Commercial
Commercial - HMO
PA Required
No Step Therapy
No Quantity Limit
See Details
Commercial - PPO
PA Required
No Step Therapy
No Quantity Limit
See Details
Commercial - Point of Service
PA Required
No Step Therapy
No Quantity Limit
See Details
Managed Medicaid
Managed Medicaid - HMO - Medicaid
No PA
No Step Therapy
No Quantity Limit
See Details
Medicare
Medicare - Medicare Advantage Part D
No PA
No Step Therapy
No Quantity Limit
See Details