CMS Formulary

Displaying 24511-24520 of 1611142 results.
ID: 24511
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 349195
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 24512
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 349198
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 24513
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 403825
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 24514
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 312439
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24515
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 198103
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24516
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 250820
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 24517
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 858751
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24518
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 858733
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24519
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 848943
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24520
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801279
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0