Standard Health Pals Formulary
Guaifenesin + Acetaminophen + Phenylephrine Tablet (Generic for Tylenol Sinus Congestion and Pain)
Coverage Level – 100%
Copay – $0
Limitations – No more than 30 days’ supply
Restrictions – Health Pals Mail Order Pharmacy Network
Comments – Generic for Tylenol Sinus Congestion and Pain