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Analgesic, Anti-Inflammatory Or AntipyreticAnestheticsAnorectal PreparationsAntidotes And Other Reversal AgentsAnti-Infective AgentsAntineoplasticsBiologicalsCardiovascular Therapy AgentsCentral Nervous System AgentsChemical Dependency, Agents To TreatChemicals-Pharmaceutical AdjuvantsCognitive Disorder TherapyContraceptivesDermatologicalDiagnostic AgentsDrugs To Treat Erectile DysfunctionEating Disorder TherapyElectrolyte Balance-Nutritional ProductsEndocrineGastrointestinal Therapy AgentsGenitourinary TherapyGout And Hyperuricemia TherapyHematological AgentsHepatobiliary System Treatment AgentsImmunosuppressive AgentsLocomotor SystemMedical Supplies And Durable Medical Equipment (Dme)Medical Supply, Fdb SupersetMetabolic Disease Enzyme Replacement AgentsMetabolic ModifiersMouth-Throat-Dental - PreparationsMultiple Sclerosis AgentsOphthalmic AgentsOtic (Ear)ProstaglandinsRespiratory Therapy AgentsVaginal Products
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Formulary Id: 11705
Formulary Effective Date: 04/12/2019
Updated:
04/2019
CMS Approval Date:
04/12/2019
CMS Version:
97

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