CMS Formulary

Displaying 22021-22030 of 1611142 results.
ID: 22021
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921228
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 22022
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988772
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 22023
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988786
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22024
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1723763
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 22025
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1723767
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 22026
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1723772
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 22027
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1726639
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 22028
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364362
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 22029
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364358
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 22030
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2473042
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30