CMS Formulary

Displaying 100021-100030 of 1611142 results.
ID: 100021
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1940372
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 100022
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2197501
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 100023
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2396770
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 28
ID: 100024
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2396774
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 28
ID: 100025
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2288433
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100026
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2288412
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 100027
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2288431
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100028
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 727816
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 100029
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650901
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 100030
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2054995
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 7
Qty Limit Days: 7