CMS Formulary

Displaying 24601-24610 of 1611142 results.
ID: 24601
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 858057
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 28
ID: 24602
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 858055
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 24603
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 858053
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 24604
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2059017
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 24605
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1232084
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 24606
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1232088
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 24607
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1114202
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 24608
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1549683
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24609
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650968
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 84
ID: 24610
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650972
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84