CMS Formulary

Displaying 23531-23540 of 1611142 results.
ID: 23531
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 349477
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23532
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 198324
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23533
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 198325
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23534
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 198323
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23535
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 855942
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 23536
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 313366
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23537
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000070
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23538
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1536586
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 23539
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 242333
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 23540
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 241527
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28