CMS Formulary

Displaying 23541-23550 of 1611142 results.
ID: 23541
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 403922
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 23542
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 402109
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23543
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 834235
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 23544
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 834241
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 23545
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 359144
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23546
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 359145
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23547
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000076
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23548
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 242892
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 23549
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1149632
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 23550
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 242891
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28