All *CHEMICALS*

Estradiol CREAM 10 %
Estradiol CREAM 10 %

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Estradiol CREAM 10 %
Estradiol CREAM 10 %

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Estriol CREAM 10 %
Estriol CREAM 10 %

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Estriol CREAM 10 %
Estriol CREAM 10 %

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Estrone CREAM 1 %
Estrone CREAM 1 %

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Estrone CREAM 1 %
Estrone CREAM 1 %

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Freedom EsterDerm Liquid
Freedom EsterDerm Liquid

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Freedom EsterDerm Liquid
Freedom EsterDerm Liquid

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Progesterone CREAM 40 %
Progesterone CREAM 40 %

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Progesterone CREAM 40 %
Progesterone CREAM 40 %

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Progesterone CREAM 40 %
Progesterone CREAM 40 %

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Testosterone CREAM 20 %
Testosterone CREAM 20 %

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N