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2021 Commercial 3 Tier Formulary

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Antihistamine DrugsAnti-Infective AgentsAntineoplastic AgentsAntitoxins,Immune Glob,Toxoids,VaccinesAutonomic DrugsBlood Formation, Coagulation, ThrombosisCardiovascular DrugsCentral Nervous System AgentsDevicesDiagnostic AgentsElectrolytic, Caloric, And Water BalanceEnzymesEye, Ear, Nose And Throat (Eent) Preps.Gastrointestinal DrugsGold CompoundsHeavy Metal AntagonistsHormones And Synthetic SubstitutesMiscellaneous Therapeutic AgentsNonhormonal ContraceptivesOxytocicsPharmaceutical AidsRespiratory Tract AgentsSkin And Mucous Membrane AgentsSmooth Muscle RelaxantsVitamins
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Formulary Effective Date: 11/01/2021
Updated:
12/2021
CMS Approval Date:
09/24/2021
CMS Version:
4

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