CMS Formulary

Displaying 23831-23840 of 1611142 results.
ID: 23831
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1651275
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 23832
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1664321
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 23833
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1667882
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 23834
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665369
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 23835
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1664328
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 23836
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1664325
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 23837
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1546083
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 23838
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796091
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 23839
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796096
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 23840
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862688
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30