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Analgesic, Anti-Inflammatory Or AntipyreticAnestheticsAnorectal PreparationsAntidotes And Other Reversal AgentsAnti-Infective AgentsAntineoplasticsAntiseptics And DisinfectantsBiologicalsCardiovascular 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)Respiratory Therapy AgentsVaginal Products
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Formulary Id: 20381
Formulary Effective Date: 10/05/2023
Updated:
09/2023
Approval Date:
09/28/2023
Version:
53

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