CMS Formulary

Displaying 24561-24570 of 1611142 results.
ID: 24561
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1727485
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 24562
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1441530
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24563
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1242998
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 24564
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2106075
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24565
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2390946
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24566
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058950
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24567
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058946
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24568
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1722376
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 63
Qty Limit Days: 28
ID: 24569
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2100099
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 180
ID: 24570
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2100100
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 180