Anthem Blue Cross (HMO, PPO, EPO)
Durysta (
bimatoprost
)
Drugs for the Eye : Drugs for Glaucoma
Zero Copay;
Quantity Limit: limit maximum 12 GM PER 30 day(s)
Prior Authorization: PA Applies
Quantity Limit: limit maximum 4 EA PER 1 day(s)
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