Drug Class: MUSCULOSKELETAL AGENTS,OTHER
VA Class Code: MS900
Therapeutic Category: MUSCULOSKELETAL MEDICATIONS
Formulary Status: PA-F Local Prior Authorization Required
Copay Tier: 3
Copay Tier Information on VA.gov
Urgent/Emergent Formulary: N
This product is on the VA national formulary and may have prior authorization requirements that are managed at the local facility level. Review the CFU documents below for requirements or contact your local VA pharmacy for additional instruction on obtaining a prior authorization for this medication.
At least one of the agents must be marked formulary, discretion is left to VISN or Facility to determine which agent(s).