CMS Formulary

Displaying 23701-23710 of 1611142 results.
ID: 23701
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 197832
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23702
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 349196
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 23703
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 349197
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 23704
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 905516
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 23705
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 905495
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 23706
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 835913
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23707
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000405
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23708
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 995232
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23709
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 977883
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23710
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 197863
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0