CMS Formulary

Displaying 24431-24440 of 1611142 results.
ID: 24431
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 199592
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 24432
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 805464
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 24433
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659927
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24434
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2046585
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 24435
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 403878
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 24436
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098143
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24437
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200174
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 24438
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200177
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 24439
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200180
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 24440
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200183
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30