Standard Health Pals Formulary
Hemorrhoid Cream with Lidocaine 5%
Coverage Level – 100%
Copay – $0
Limitations – No more than 30 days’ supply
Restrictions – Health Pals Mail Order Pharmacy Network
Comments – Equivalent to Preparation H
Coverage Level – 100%
Copay – $0
Limitations – No more than 30 days’ supply
Restrictions – Health Pals Mail Order Pharmacy Network
Comments – Equivalent to Preparation H
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