CMS Formulary

Displaying 22821-22830 of 1611142 results.
ID: 22821
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 665040
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 22822
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 744846
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22823
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 665036
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 22824
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547114
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 22825
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547118
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 22826
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1235595
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22827
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 1235591
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22828
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 668606
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22829
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 861821
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 22830
Formulary ID: 00021007
Formulary Version: 14
Contract Year: 2021
RXCUI: 861771
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30