CMS Formulary

Displaying 23651-23660 of 1611142 results.
ID: 23651
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433223
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 23652
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433229
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 23653
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433235
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 23654
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433241
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 23655
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307309
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 23656
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2052609
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23657
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2052704
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23658
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105817
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 23659
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300797
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23660
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300803
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0