Sample Notes Page - CareFirst BlueCross BlueShield
Prescription Drug Detail

Brand Name
Brand Tier
Generic Name
Generic Tier
PEPCID 40 mg
 
(Tier 3)
 
famotidine 40 mg
(Tier 1)

Prior Authorization Required: No
Quantity Limit: No
Category: Stomach & Digestive disorders\acid & stomach ulcers
Maintenance Drug: Yes
Notes: Only the 40 mg is available by prescription (10 and 20 mg are OTC).wjp
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