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(4) The payment limits for supplying and administering a drug covered as an additional preventive service, as defined at 410.64, appear on the DCAPS fee schedule and are determined as follows: (i) For a drug that is supplied by a pharmacy, the payment limit for a supplying fee is as follows: (A) For the first prescription that the pharmacy provides to a beneficiary in a 30-day period for a drug covered as an additional preventive service, $24

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