Sutter Health Plus
Kroger HealthPro Glucose Test (
blood sugar diagnostic
)
Medical Supplies and Durable Medical Equipment : Medical Supplies and Durable Medical Equipment
Quantity Limit: 3 capsules per 1 day(s).
Prior Authorization: PA_APPLIES
Quantity Limit: 4 tablet per 1 day(s).
Step Therapy: ST_APPLIES
PA Applies
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