CMS Formulary

Displaying 23021-23030 of 1611142 results.
ID: 23021
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047623
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 23022
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2463737
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 23023
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2463733
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 23024
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105856
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 23025
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2168548
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 23026
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058932
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 23027
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1148506
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 23028
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1148502
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 23029
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2168540
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 23030
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 207088
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0