CMS Formulary

Displaying 22511-22520 of 1611142 results.
ID: 22511
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 314266
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 22512
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 749784
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22513
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 644088
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 22514
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603861
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 22515
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251336
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22516
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 749157
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22517
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 748798
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22518
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989507
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22519
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876920
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 22520
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876924
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30