CMS Formulary

Displaying 23561-23570 of 1611142 results.
ID: 23561
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 748878
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23562
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1111641
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 23563
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1487361
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 23564
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 351137
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 23565
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 351136
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 23566
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 199689
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23567
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 603208
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 23568
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 603203
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 23569
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 603206
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 23570
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 748961
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0