AcipHex Sprinkle CAPSULE SPRINKLE 5 MG Oral

RABEprazole Sodium

Strength: 5cm (L)

Medication Description

AcipHex Sprinkle CAPSULE SPRINKLE 5 MG Oral

Medication Features

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