All *ESTROGENS*

Activella Tablet 0.5-0.1 MG Oral
Activella Tablet 0.5-0.1 MG Oral

Estradiol-Norethindrone Acet

Tier: 3
PA Type: No Prior Authorization
ST: N
Activella Tablet 1-0.5 MG Oral
Activella Tablet 1-0.5 MG Oral

Estradiol-Norethindrone Acet

Tier: 3
PA Type: No Prior Authorization
ST: N
Activella Tablet 1-0.5 MG Oral
Activella Tablet 1-0.5 MG Oral

Estradiol-Norethindrone Acet

Tier: 3
PA Type: No Prior Authorization
ST: N
Alora Patch Twice Weekly 0.025 MG/24HR Transdermal
Alora Patch Twice Weekly 0.025 MG/24HR Transdermal

Estradiol

Tier: 3
PA Type: No Prior Authorization
ST: N
Alora Patch Twice Weekly 0.025 MG/24HR Transdermal
Alora Patch Twice Weekly 0.025 MG/24HR Transdermal

Estradiol

Tier: 3
PA Type: No Prior Authorization
ST: N
Alora Patch Twice Weekly 0.025 MG/24HR Transdermal
Alora Patch Twice Weekly 0.025 MG/24HR Transdermal

Estradiol

Tier: 3
PA Type: No Prior Authorization
ST: N
Alora Patch Twice Weekly 0.025 MG/24HR Transdermal
Alora Patch Twice Weekly 0.025 MG/24HR Transdermal

Estradiol

Tier: 3
PA Type: No Prior Authorization
ST: N
Alora Patch Twice Weekly 0.05 MG/24HR Transdermal
Alora Patch Twice Weekly 0.05 MG/24HR Transdermal

Estradiol

Tier: 3
PA Type: No Prior Authorization
ST: N
Alora Patch Twice Weekly 0.05 MG/24HR Transdermal
Alora Patch Twice Weekly 0.05 MG/24HR Transdermal

Estradiol

Tier: 3
PA Type: No Prior Authorization
ST: N
Alora Patch Twice Weekly 0.05 MG/24HR Transdermal
Alora Patch Twice Weekly 0.05 MG/24HR Transdermal

Estradiol

Tier: 3
PA Type: No Prior Authorization
ST: N
Alora Patch Twice Weekly 0.05 MG/24HR Transdermal
Alora Patch Twice Weekly 0.05 MG/24HR Transdermal

Estradiol

Tier: 3
PA Type: No Prior Authorization
ST: N
Alora Patch Twice Weekly 0.075 MG/24HR Transdermal
Alora Patch Twice Weekly 0.075 MG/24HR Transdermal

Estradiol

Tier: 3
PA Type: No Prior Authorization
ST: N