Silver
| Strength: | 4"X4-3/4"cm (L) |
Medication Description
Acticoat Surgical PAD 4″X4-3/4″ EXTERNAL
Medication Features
| Tier | Non-Formulary |
| PA Type | No Prior Authorization |
| ST | N |
Silver
| Strength: | 4"X4-3/4"cm (L) |
Acticoat Surgical PAD 4″X4-3/4″ EXTERNAL
| Tier | Non-Formulary |
| PA Type | No Prior Authorization |
| ST | N |