CMS Formulary

Displaying 22631-22640 of 1611142 results.
ID: 22631
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1940654
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 22632
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1944382
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 22633
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1944376
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 22634
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921081
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 22635
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1866047
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22636
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099026
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22637
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099269
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22638
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1006065
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22639
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1020155
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 22640
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1720616
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0