CMS Formulary

Displaying 22791-22800 of 1611142 results.
ID: 22791
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1731317
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 28
ID: 22792
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 643177
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 22793
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 643173
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 22794
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 643175
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 22795
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 799830
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 22796
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1045408
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 22797
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1045404
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 22798
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364441
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 22799
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364447
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 22800
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1145932
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0