CMS Formulary

Displaying 24261-24270 of 1611142 results.
ID: 24261
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 905100
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 24262
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1095712
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24263
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665515
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24264
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1719286
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24265
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 313115
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24266
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 239240
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24267
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 809871
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 20
Qty Limit Days: 30
ID: 24268
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 864661
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24269
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001424
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24270
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1363408
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28