AcipHex Sprinkle Capsule Sprinkle 10 MG Oral

RABEprazole Sodium

Strength: 10cm (L)

Medication Description

AcipHex Sprinkle Capsule Sprinkle 10 MG Oral

Medication Features

Tier 3
PA Type No Prior Authorization
ST N
QL Y
QL Amount 60
QL Days 30