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A drug with a termination date will appear on the search for 90 days following the termination date.
| Brand Name/Generic Name/Package Size | NDC/Manufacturer/Class | PA Required | Programs/Coverage Dates |
|---|---|---|---|
| KYLEENA 19.5 MG SYSTEM levonorgestrel 1 EA |
50419042401 BAYER,PHARM DIV |
FFS Clinical: No PDL: No |
Medicaid start: 08/02/2017 HTW start: 08/02/2017 |