| Anthem Blue Cross (HMO, PPO, EPO) |
| dalfampridine (dalfampridine) |
| Drugs for the Nervous System : Drugs for Multiple Sclerosis |
- Quantity Limit: 30 tablets per
prescription
- Step Therapy: ST_APPLIES
- Step Therapy: Diabetes Type 2: GLP1 + Combo:
ST Multiple Brands
- Available through Specialty Pharmacy;
|