CMS Formulary

Displaying 23401-23410 of 1611142 results.
ID: 23401
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 308048
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 23402
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 197321
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 23403
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 197322
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 23404
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 198033
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23405
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 197444
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23406
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 197445
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23407
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 197816
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23408
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 197815
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23409
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1001004
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23410
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 351264
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30