CMS Formulary

Displaying 24651-24660 of 1611142 results.
ID: 24651
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2166401
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 24652
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1999389
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 24653
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1812470
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 24654
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1655934
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 24655
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2053512
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 24656
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 904158
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24657
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 861495
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24658
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 197407
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24659
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 310364
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24660
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 238920
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0