CMS Formulary

Displaying 23911-23920 of 1611142 results.
ID: 23911
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 403852
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23912
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 730988
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23913
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 349556
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 23914
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 240741
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23915
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 309322
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23916
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 476576
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23917
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 617423
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23918
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 617993
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23919
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 314227
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 23920
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 142046
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0