CMS Formulary

Displaying 23921-23930 of 1611142 results.
ID: 23921
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 238004
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 23922
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 313921
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 23923
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 238003
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 23924
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 403923
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 23925
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 241946
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 23926
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 198322
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23927
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 308962
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23928
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 991039
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23929
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 991194
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23930
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 991336
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0