CMS Formulary

Displaying 24201-24210 of 1611142 results.
ID: 24201
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 313761
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 24202
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 884173
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24203
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 884185
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24204
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 884189
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24205
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099625
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24206
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 996571
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 24207
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 996561
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 24208
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 854916
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24209
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 854919
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24210
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 854908
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0