CMS Formulary

Displaying 23811-23820 of 1611142 results.
ID: 23811
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 197383
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23812
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 197382
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23813
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 805515
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23814
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 603378
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23815
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1190225
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 30
ID: 23816
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 580261
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 23817
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 836368
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 25
Qty Limit Days: 28
ID: 23818
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1552004
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 23819
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1723478
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 23820
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1430453
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30