CMS Formulary

Displaying 23071-23080 of 1611142 results.
ID: 23071
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 847734
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23072
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 860244
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 30
ID: 23073
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1002300
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 23074
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 998191
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 23075
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1012899
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 23076
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1119402
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 23077
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310138
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 23078
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310144
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 23079
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310147
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 23080
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364114
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30