CMS Formulary

Displaying 23091-23100 of 1611142 results.
ID: 23091
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 867506
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 23092
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1425230
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 23093
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1425228
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 23094
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1245003
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 23095
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 825425
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 23096
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 825429
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 23097
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 884619
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 23098
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2121061
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 28
ID: 23099
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1656356
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23100
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1859501
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30