CMS Formulary

Displaying 24271-24280 of 1611142 results.
ID: 24271
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1363410
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 24272
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364581
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 24273
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790175
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 24274
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790167
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 24275
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790171
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 24276
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1928941
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 24277
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 197703
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24278
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300783
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24279
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 831261
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24280
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 829500
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0