Standard Health Pals Formulary
Cefazolin 3 gm Vial for Infusion (Generic for Ancef)
Coverage Level – 100%
Copay – $0
Limitations – No more than 30 days’ supply
Restrictions – Health Pals Mail Order Pharmacy Network
Comments – Must be shipped to either a Physician’s office or an Infusion Clinic; Generic for Ancef