CMS Formulary

Displaying 24241-24250 of 1611142 results.
ID: 24241
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 859424
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 24242
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 859747
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 24243
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 859751
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 24244
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 859419
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 24245
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 199192
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24246
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 199193
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24247
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 198382
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24248
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 997226
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 24249
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 997220
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 24250
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 349201
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0