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Alternative Therapy - Vitamins And Minerals
Analgesic, Anti-Inflammatory Or Antipyretic
Analgesic, Anti-Inflammatory Or Antipyretic - Drugs For Pain And Fever
Anesthetics - Drugs For Pain And Fever
Anorectal Preparations - Rectal Preparations
Antidotes And Other Reversal Agents - Drugs For Overdose Or Poisoning
Anti-Infective Agents
Anti-Infective Agents - Drugs For Infections
Antineoplastics
Antineoplastics - Drugs For Cancer
Antiseptics And Disinfectants - Antiseptics And Disinfectants
Biologicals
Biologicals - Biological Agents
Cardiovascular Therapy Agents
Cardiovascular Therapy Agents - Drugs For The Heart
Central Nervous System Agents
Central Nervous System Agents - Drugs For The Nervous System
Chemical Dependency, Agents To Treat - Drugs For Addiction
Chemicals-Pharmaceutical Adjuvants
Cognitive Disorder Therapy
Cognitive Disorder Therapy - Drugs For The Nervous System
Contraceptives - Drugs For Women
Dermatological
Dermatological - Drugs For The Skin
Diagnostic Agents
Drugs To Treat Erectile Dysfunction - Drugs For The Urinary System
Electrolyte Balance-Nutritional Products
Electrolyte Balance-Nutritional Products - Drugs For Nutrition
Endocrine
Endocrine - Hormones
Enzymes - Vitamins And Minerals
Gastrointestinal Therapy Agents
Gastrointestinal Therapy Agents - Drugs For The Stomach
Genitourinary Therapy - Drugs For The Urinary System
Gout And Hyperuricemia Therapy - Drugs For Pain And Fever
Hematological Agents
Hematological Agents - Drugs For The Blood
Hepatobiliary System Treatment Agents
Hepatobiliary System Treatment Agents - Drugs For The Liver
Immunosuppressive Agents - Drugs For Organ Transplants
Locomotor System
Locomotor System - Drugs For Muscles, Ligaments, Tendons, And Bones
Medical Supplies And Durable Medical Equipment (Dme) - Medical Supplies And Durable Medical Equipment
Medical Supply, Fdb Superset
Metabolic Disease Enzyme Replacement Agents - Drugs For Metabolic Disease
Metabolic Modifiers
Metabolic Modifiers - Drugs That Alter Metabolism
Mouth-Throat-Dental - Preparations - Drugs For The Mouth And Throat
Multiple Sclerosis Agents - Drugs For The Nervous System
Ophthalmic Agents
Ophthalmic Agents - Drugs For The Eye
Organ Preservation Solutions - Drugs For The Heart
Otic (Ear) - Drugs For The Ear
Renal Replacement Therapy - Drugs For The Kidneys
Respiratory Therapy Agents
Respiratory Therapy Agents - Drugs For The Lungs
Vaginal Products - Drugs For Women
Weight Loss/Gain Agents
Weight Loss/Gain Agents - Drugs For Eating Disorders
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Terms of Use
Formulary Id:
24660
Formulary Effective Date:
05/16/2025
Updated:
05/2025
Approval Date:
05/09/2025
Version:
21
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