CMS Formulary

Displaying 23881-23890 of 1611142 results.
ID: 23881
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 403810
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 23882
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 403811
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 23883
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806195
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 23884
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806179
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 23885
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806183
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 23886
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 308191
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23887
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 199119
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23888
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 864110
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23889
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 854302
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23890
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1793916
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28