Womens Health
Oral Contraceptives, Monophasic

Brand/Generic Name
(Generics in italics)		 Dosage/Strength Status Restrictions Notes
Yasmin 28 generic.gif (400 bytes)
Drospirenone-Ethinyl Estradiol		   nonform.gif (510 bytes)    

Key for Product(s) Listed Above
Formulary
Non-Formulary
Generic is Formulary, Brand is Non-Formulary
Prior Authorization
Quantity Limit Step Therapy Notes  

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