CMS Formulary

Displaying 22721-22730 of 1611142 results.
ID: 22721
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2262446
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 22722
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123034
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22723
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2274390
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 22724
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2282320
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 30
ID: 22725
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1591943
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 22726
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799212
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 22727
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659183
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 22728
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659161
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 22729
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2467571
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 22730
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2467575
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30