CMS Formulary

Displaying 22091-22100 of 1611142 results.
ID: 22091
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 794641
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 22092
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 617768
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 22093
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790892
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 22094
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790886
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 22095
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790890
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 22096
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2384465
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 28
ID: 22097
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1670324
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 80
Qty Limit Days: 28
ID: 22098
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1670322
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 28
ID: 22099
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 309952
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22100
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 197622
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0