CMS Formulary

Displaying 24441-24450 of 1611142 results.
ID: 24441
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648755
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 24442
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 725021
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 24443
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 725023
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 24444
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 311994
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 24445
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 311995
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 24446
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648759
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 24447
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307061
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 24448
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1115698
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 180
ID: 24449
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1308569
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 24450
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 351209
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0