Brompheniramine Tannate Tablet Chewable 12 MG Oral
Tier: 3
PA Type: No Prior Authorization
ST: N
Carbinoxamine Maleate Solution 4 MG/5ML Oral
Tier: 3
PA Type: No Prior Authorization
ST: N
Carbinoxamine Maleate Solution 4 MG/5ML Oral
Tier: 1
PA Type: No Prior Authorization
ST: N
Carbinoxamine Maleate Solution 4 MG/5ML Oral
Tier: 1
PA Type: No Prior Authorization
ST: N
Carbinoxamine Maleate Tablet 4 MG Oral
Tier: 1
PA Type: No Prior Authorization
ST: N
Carbinoxamine Maleate Tablet 4 MG Oral
Tier: 3
PA Type: No Prior Authorization
ST: N
Carbinoxamine Maleate Tablet 4 MG Oral
Tier: 1
PA Type: No Prior Authorization
ST: N
Carbinoxamine Maleate Tablet 6 MG Oral
Tier: 3
PA Type: No Prior Authorization
ST: N
Cetirizine HCl Solution 1 MG/ML Oral
Tier: 1
PA Type: No Prior Authorization
ST: N
Cetirizine HCl Solution 1 MG/ML Oral
Tier: 1
PA Type: No Prior Authorization
ST: N
Cetirizine HCl Solution 1 MG/ML Oral
Tier: 1
PA Type: No Prior Authorization
ST: N