Transcription of Extemporaneous Compounds Policy - providerConnect
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Extemporaneous Compounds Policy - providerConnect
Extemporaneous Compounds Policy Topical Extemporaneous Compounds Eligible Ingredients Eligible Bases Camphor Benzoin Tincture Liquor Carbonis Detergens (LCD) Coal Tar Menthol Salicylic Acid Sulfur Tar Distallate Erythromycin Powder Clindamycin Powder Ketoconazole Powder Aquaphor Ointment (02009609) Dermabase (00067350) Glax al Base (00295604) Anhydrous Lanolin (50725) Petrolatum Jelly (00094854) Eucerin Ointment (00900907) Rougier Base (00964956) Mediderm Cream Base (00961582) Transal Base (00962511) Metronidazole Powder Clotrimazole Powder Miconazole Powder One or more of any of the Eligible Ingredients may be added to: 1.
benefits of Green Shield Canada (GSC) product. stadil powder or to be considered for coverage as a benefit. Although the GSC as eligible ingredients, it is recognized that these excipients are necessary for some compounds. The addition of such agents in small amounts will not render the entire compound ineligible. However, in
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