CMS Formulary

Displaying 24701-24710 of 1611142 results.
ID: 24701
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2287905
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 24702
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2056700
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 24703
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1358775
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24704
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 751884
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24705
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1011081
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24706
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1112687
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 24707
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 748879
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24708
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 834768
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24709
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 748859
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 24710
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 751875
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0