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Formulary ID: 22378

Book: 4 & 5

This plan participates in the Part D Senior Savings Model for Insulin. Eligible members will pay no more than $35 for a 30-day supply of covered select insulin medications. See Evidence of Coverage for complete details.


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Formulary Id: 22378
Formulary Effective Date: 08/01/2022
Updated:
08/2022

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