All *PROGESTINS*

Aygestin TABLET 5 MG ORAL
Aygestin TABLET 5 MG ORAL

Norethindrone Acetate

Tier: 3
PA Type: No Prior Authorization
ST: N
EC-RX Progesterone CREAM 10 % TRANSDERMAL
EC-RX Progesterone CREAM 10 % TRANSDERMAL

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
EC-RX Progesterone CREAM 10 % TRANSDERMAL
EC-RX Progesterone CREAM 10 % TRANSDERMAL

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
EC-RX Progesterone CREAM 20 % TRANSDERMAL
EC-RX Progesterone CREAM 20 % TRANSDERMAL

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
EC-RX Progesterone CREAM 20 % TRANSDERMAL
EC-RX Progesterone CREAM 20 % TRANSDERMAL

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
HYDROXYprogesterone Caproate Oil 250 MG/ML Intramuscular
HYDROXYprogesterone Caproate Oil 250 MG/ML Intramuscular

Tier: 1
PA Type: PA Applies
PA Group: Makena
HYDROXYprogesterone Caproate Oil 250 MG/ML Intramuscular
HYDROXYprogesterone Caproate Oil 250 MG/ML Intramuscular

Tier: 1
PA Type: PA Applies
PA Group: Makena
HYDROXYprogesterone Caproate Oil 250 MG/ML Intramuscular
HYDROXYprogesterone Caproate Oil 250 MG/ML Intramuscular

Tier: 1
PA Type: PA Applies
PA Group: Makena
HYDROXYprogesterone Caproate Oil 250 MG/ML Intramuscular
HYDROXYprogesterone Caproate Oil 250 MG/ML Intramuscular

Tier: 1
PA Type: PA Applies
PA Group: Makena
HYDROXYprogesterone Caproate Oil 250 MG/ML Intramuscular
HYDROXYprogesterone Caproate Oil 250 MG/ML Intramuscular

Tier: 1
PA Type: PA Applies
PA Group: Makena
HYDROXYprogesterone Caproate Oil 250 MG/ML Intramuscular
HYDROXYprogesterone Caproate Oil 250 MG/ML Intramuscular

Tier: 1
PA Type: PA Applies
PA Group: Makena
HYDROXYprogesterone Caproate Oil 250 MG/ML Intramuscular
HYDROXYprogesterone Caproate Oil 250 MG/ML Intramuscular

Tier: 1
PA Type: PA Applies
PA Group: Makena