| Strength: | 80&0.25&1cm (L) |
Medication Description
Active Injection LM-DEP-1 Kit 80 & 0.25 & 1 MG/ML-%-% Injection
Medication Features
| Tier | Non-Formulary |
| PA Type | No Prior Authorization |
| ST | N |
| Strength: | 80&0.25&1cm (L) |
Active Injection LM-DEP-1 Kit 80 & 0.25 & 1 MG/ML-%-% Injection
| Tier | Non-Formulary |
| PA Type | No Prior Authorization |
| ST | N |