CMS Formulary

Displaying 9021-9030 of 1611142 results.
ID: 9021
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364358
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 9022
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 2473042
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 9023
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049271
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 9024
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049278
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 9025
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 197518
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 9026
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 284215
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 9027
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 544840
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 9028
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 313165
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 9029
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 865129
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 9030
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 1807513
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0