| Kaiser Foundation Health Plan Northern California - All plan years |
| Sunosi (solriamfetol) |
| Drugs for the Nervous System : Drugs for Sleep Disorder |
- Anti-Cancer: Maximum $200 copayment per State Law. Must use AcariaHealth Specialty Rx.
- Quantity Limit: limit maximum 12 ML PER 28 day(s)
- Quantity Limit: limit maximum 5 mL PER 30 day(s)
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