CMS Formulary

Displaying 23791-23800 of 1611142 results.
ID: 23791
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 238134
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 23792
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1745091
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 23793
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801289
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23794
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 311892
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23795
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 311893
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23796
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 199521
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 23797
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 198076
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23798
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 198077
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23799
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 198078
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23800
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 198075
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0