Sample Notes Page - CareFirst BlueCross BlueShield
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Prescription Drug Detail
Brand Name
Brand Tier
Generic Name
Generic Tier
DIFFERIN
(Tier
3
)
adapalene
(Tier
1
)
Prior Authorization Required:
Yes
Quantity Limit:
No
Category:
Skin\acne
Maintenance Drug:
No
Notes:
This medication requires Prior Authorization. Please have your physician call 1-800-314-2872 before prescribing this medication. Generic available for 0.1mg strength only.
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