CMS Formulary

Displaying 24301-24310 of 1611142 results.
ID: 24301
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 891874
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 24302
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 892646
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 24303
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 848726
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 24304
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 848738
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 24305
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 848742
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 24306
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 848746
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 24307
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 848750
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 24308
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 848730
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 24309
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 848734
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 24310
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 848752
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0