HMSA QUEST Formulary eff 10/01/2019

HMSA QUEST Integration Managed Medicaid Formulary (Effective 12/01/2019) LEGEND AL Age Limit OTC Over the Counter PA Prior Authorization QL Quantity Limit SP Specialty Drug ST Step Therapy + Indicates both the generic is covered as well as the brand-name product equivalent, with dispense as written code 1 (DAW 1). This ................
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