32:00 Contraceptives (Non-Oral)
32:00.00 CONTRACEPTIVES (NON-ORAL)
CONDOM
Drug strength and dosage form | DIN | Brand name | Manufacturer code |
---|---|---|---|
Device | 99400527 | CONDOM, LATEX, LUBRICATED | UNK |
Device | 99400486 | CONDOM, LATEX, NON-LUBRICATED | UNK |
Device | 99400786 | CONDOM, NON-LATEX, LUBRICATED | UNK |
Device | 09991648 | FC2 FEMALE CONDOMS | UNK |
CONTRACEPTIVE
Drug strength and dosage form | DIN | Brand name | Manufacturer code |
---|---|---|---|
Device | 09991647 | TODAY SPONGE VAGINAL CONTRACEPTIVE | UNK |
Device | 09991646 | VCF VAGINAL CONTRACEPTIVE FILM | UNK |
Foam | 09991645 | VCF FOAM VAGINAL CONTRACEPTIVE | UNK |
CONTRACEPTIVE DEVICE
Drug strength and dosage form | DIN | Brand name | Manufacturer code |
---|---|---|---|
Device | 00970905 | CAYA CONTOURED DIAPHRAGM | TSN |
FEMCAP
Drug strength and dosage form | DIN | Brand name | Manufacturer code |
---|---|---|---|
Device | 09991642 | CERVICAL | UNK |
INTRAUTERINE DEVICE
Limited use benefit with quantity and frequency limits (prior approval is not required).
Coverage is granted for 1 device every 12 months.
Drug strength and dosage form | DIN | Brand name | Manufacturer code |
---|---|---|---|
Device | 00970328 | FLEXI-T +300 IUD | TSN |
Device | 00970336 | FLEXI-T +380 IUD | TSN |
Device | 98099999 | FLEXI-TD | TSN |
Device | 99401085 | LIBERTE UT380 SHORT IUD | MSF |
Device | 99401086 | LIBERTE UT380 STANDARD IUD | MSF |
Device | 00970379 | MONA LISA 10 | SEA |
Device | 00970387 | MONA LISA 5 | SEA |
Device | 00970395 | MONA LISA N | SEA |
Device | 99400482 | NOVA-T | BEX |