Standard Health Pals Formulary
Efavirenz 600 mg / Emtricitabine 200 mg / Tenofovir Disoproxil 300 mg (Generic for Atripla)
Coverage Level – 100%
Copay – $0
Limitations – No more than 90 days’ supply
Restrictions – Health Pals Mail Order Pharmacy Network
Comments – Generic for Atripla