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Wegovy j code 2022 Non-HMO Drug List. Contraceptive Coverage List. ACA $0 Preventive Drug List. $0 HDHP-HSA Preventive Drug List (This applies only for Blue PPO Gold SM 113 and Blue Choice Preferred Gold PPO SM 113 plans) Starting January 1, 2022, some changes will be made to the prescription drug benefit. Review the 2022 changes.

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