CMS Formulary

Displaying 22121-22130 of 1611142 results.
ID: 22121
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2399904
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 22122
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098141
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22123
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098134
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22124
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 577033
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 22125
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 995624
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22126
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2266506
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 22127
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 857336
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22128
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 857321
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22129
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 857328
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22130
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 857340
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0