All *PENICILLINS*

Amoxicillin Capsule 250 MG Oral
Amoxicillin Capsule 250 MG Oral

Tier: 1
PA Type: No Prior Authorization
ST: N
Amoxicillin Capsule 250 MG Oral
Amoxicillin Capsule 250 MG Oral

Tier: 1
PA Type: No Prior Authorization
ST: N
Amoxicillin Capsule 250 MG Oral
Amoxicillin Capsule 250 MG Oral

Tier: 1
PA Type: No Prior Authorization
ST: N
Amoxicillin Capsule 250 MG Oral
Amoxicillin Capsule 250 MG Oral

Tier: 1
PA Type: No Prior Authorization
ST: N
Amoxicillin Capsule 250 MG Oral
Amoxicillin Capsule 250 MG Oral

Tier: 1
PA Type: No Prior Authorization
ST: N
Amoxicillin Capsule 250 MG Oral
Amoxicillin Capsule 250 MG Oral

Tier: 1
PA Type: No Prior Authorization
ST: N
Amoxicillin Capsule 250 MG Oral
Amoxicillin Capsule 250 MG Oral

Tier: 1
PA Type: No Prior Authorization
ST: N
Amoxicillin Capsule 250 MG Oral
Amoxicillin Capsule 250 MG Oral

Tier: 1
PA Type: No Prior Authorization
ST: N
Amoxicillin Capsule 250 MG Oral
Amoxicillin Capsule 250 MG Oral

Tier: 1
PA Type: No Prior Authorization
ST: N
Amoxicillin Capsule 250 MG Oral
Amoxicillin Capsule 250 MG Oral

Tier: 1
PA Type: No Prior Authorization
ST: N
Amoxicillin Capsule 250 MG Oral
Amoxicillin Capsule 250 MG Oral

Tier: 1
PA Type: No Prior Authorization
ST: N
Amoxicillin Capsule 250 MG Oral
Amoxicillin Capsule 250 MG Oral

Tier: 1
PA Type: No Prior Authorization
ST: N