Standard Health Pals Formulary
Norethindrone 1 mg / Ethinyl Estradiol 0.02 mg with Ferrous Fumarate Tablet Pack (Generic for Minastrin 24 FE and Melode 24 FE)
Coverage Level – 100%
Copay – $0
Limitations – No more than 90 days’ supply
Restrictions – Health Pals Mail Order Pharmacy Network
Comments – Generic for Melode 24 FE; Generic for Minastrin 24 FE