Additional information
Formulary Category | 3 |
---|---|
Restrictions | Step Therapy |
What we cover | Non-Formulary Brand |
Cost* | $68 |
Cost mail** | $68 |
Sodium Picosulfate-Magnesium Oxide-Anhydrous Citric Acid Soln (Generic)
Formulary Category | 3 |
---|---|
Restrictions | Step Therapy |
What we cover | Non-Formulary Brand |
Cost* | $68 |
Cost mail** | $68 |