Standard Health Pals Formulary
Ipratropium 0.03% Nasal Spray Inhalation Solution (Generic for Atrovent Nasal Spray Solution 0.03%)
Coverage Level – 100%
Copay – $0
Limitations – No more than 90 days’ supply
Restrictions – Health Pals Mail Order Pharmacy Network
Comments – Generic for Atrovent Nasal Spray Solution 0.03%