CMS Formulary

Displaying 23011-23020 of 1611142 results.
ID: 23011
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 616292
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 23012
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1357547
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23013
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2048568
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23014
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2478437
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23015
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099956
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 23016
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058926
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 23017
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047602
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 23018
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047608
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 23019
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047614
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 23020
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047596
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28