CMS Formulary

Displaying 22731-22740 of 1611142 results.
ID: 22731
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2472789
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22732
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2478450
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 22733
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2369403
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 22734
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1594673
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22735
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 905059
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 22736
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 905064
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84
ID: 22737
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 905057
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 168
ID: 22738
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251334
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22739
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1487076
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 224
Qty Limit Days: 28
ID: 22740
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1368459
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0