Anthem Blue Cross (HMO, PPO, EPO)
Viibryd 10 Mg (7)-20 Mg (7)-40 Mg (16) DsPk (
vilazodone
)
Drugs for the Nervous System : Drugs for Depression
Quantity Limit: limit maximum 10 EA PER 1 day(s)
Anti-Cancer:Maximum $200 copayment per State Law.
PA_APPLIES
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