CMS Formulary

Displaying 24221-24230 of 1611142 results.
ID: 24221
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 197817
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 24222
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 197818
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 24223
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 197889
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24224
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 855172
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24225
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 242679
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24226
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 309313
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 600
Qty Limit Days: 30
ID: 24227
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 351285
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24228
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123194
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 24229
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 313565
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24230
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 313564
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0