CMS Formulary

Displaying 22771-22780 of 1611142 results.
ID: 22771
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2370174
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 22772
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2170613
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 30
ID: 22773
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2395785
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 22774
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2370170
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 22775
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047247
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22776
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2256947
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 30
ID: 22777
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1946836
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 22778
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2256943
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 30
ID: 22779
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 2205474
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22780
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1946840
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28