CMS Formulary

Displaying 23281-23290 of 1611142 results.
ID: 23281
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 856940
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2700
Qty Limit Days: 30
ID: 23282
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 834137
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23283
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 810002
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 23284
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 809990
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 23285
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 809994
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 23286
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 809998
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 23287
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 995156
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 23288
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 308963
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23289
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 317173
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 23290
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 308964
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0