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Publication: Formulary List
The form made available on this page is provided in its most recent version and is available to view or print in a PDF format PDF. If you have trouble viewing or printing the form, then please consult the help page for assistance. To order this form, please visit the form order page for instructions.
Form Name> Formulary List (Medicare) PDF
Form Code --
Last Revised Date 2013
Next Revision Date None expected at this time
This document is a list of the most commonly prescribed drugs. It represents an abbreviated version of the drug list (formulary) that is at the core of your prescription drug plan. This list is not all-inclusive and does not guarantee coverage.
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