CMS Formulary

Displaying 24621-24630 of 1611142 results.
ID: 24621
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251914
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 24622
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 722256
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 24623
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251918
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 24624
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 724142
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 24625
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 724156
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 24626
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251922
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 24627
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1739788
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 600
Qty Limit Days: 30
ID: 24628
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1149617
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 24629
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 866427
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24630
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 866412
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0