CMS Formulary

Displaying 24471-24480 of 1611142 results.
ID: 24471
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 577324
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24472
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 727316
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 24473
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870207
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 24474
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1374574
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 224
Qty Limit Days: 28
ID: 24475
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2003255
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24476
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2198370
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 24477
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 865208
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 24478
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 865212
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 24479
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 865216
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 24480
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 723827
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0