| Western Health Advantage - All plan years |
| Kalydeco (ivacaftor) |
| Drugs for the Lungs : Drugs for Cystic Fibrosis |
- Quantity Limit: 1 fill per 180 day(s).
- Step Therapy: Myelodysplastic Syndrome:
ST Single Brand
- Quantity Limit: limit maximum 2 EA PER 1 day(s)
- PA_APPLIES
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