
Ana-Lex Kit 2-2 % Rectal
Lidocaine-Hydrocortisone Ace
Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N

Ana-Lex Kit 2-2 % Rectal
Lidocaine-Hydrocortisone Ace
Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N

Analpram HC Cream 2.5-1 % External
Hydrocort-Pramoxine (Perianal)
Tier: 3
PA Type: No Prior Authorization
ST: N

Analpram HC Cream 2.5-1 % External
Hydrocort-Pramoxine (Perianal)
Tier: 3
PA Type: No Prior Authorization
ST: N

Analpram HC Cream 2.5-1 % External
Hydrocort-Pramoxine (Perianal)
Tier: 3
PA Type: No Prior Authorization
ST: N

Analpram HC Singles Cream 2.5-1 % External
Hydrocort-Pramoxine (Perianal)
Tier: 3
PA Type: No Prior Authorization
ST: N

Analpram-HC Cream 1-1 % External
Hydrocortisone Ace-Pramoxine
Tier: 3
PA Type: No Prior Authorization
ST: N
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