PharmD_Rodriguez said:

The shortage clause is the answer to the second question and it is a subtraction rather than an addition.

That is correct as far as it goes, and here is where it stops going. Worth adding the genuine exception, because it is real and narrow: a change made for an identified patient where the prescriber determines it produces a significant clinical difference for that patient. A grid of fixed doses offered to everybody is not that, whatever the intake form says.

InsuranceTom said:

True, though the ladder is longer and that is not a neutral detail — six dose steps means six opportunities to stall on the way up, and plenty of…

That reframing is the part I needed.

PharmD_Rodriguez said:

The shortage clause is the answer to the second question and it is a subtraction rather than an addition.

I read this differently from PharmD_Rodriguez, on substance rather than tone. A research-chemical supplier selling lyophilised powder labelled research use only is not compounding and is not claiming to. It is a different legal universe with no pharmacy oversight, no patient relationship and no content guarantee, and conflating the two in these threads helps nobody.

One concrete data point for the thread. One practical note: write down what you did and when, before you need it. Reconstructing a timeline from memory three months later is how people end up unable to answer the one question that would have resolved it.

Moderator note: leaving this open. It is being argued well and the disagreement is the useful part.