CMS Formulary

Displaying 24021-24030 of 1611142 results.
ID: 24021
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 855189
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24022
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 602964
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 24023
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 402131
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 24024
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 349545
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 24025
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 349490
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 24026
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 349553
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 24027
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 349547
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 24028
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 856373
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24029
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 310288
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24030
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 197985
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0