CMS Formulary

Displaying 24291-24300 of 1611142 results.
ID: 24291
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650143
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24292
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298910
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 24293
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298816
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 24294
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298906
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 24295
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 858613
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24296
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 858616
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24297
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 858747
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24298
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 891881
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 24299
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 891888
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 24300
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 891893
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30