CMS Formulary

Displaying 9721-9730 of 1611142 results.
ID: 9721
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 2467571
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 9722
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 2467575
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 9723
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 2472789
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 9724
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 2478450
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 9725
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 2369403
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 9726
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 1594673
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 9727
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 905059
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 9728
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 905064
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84
ID: 9729
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 905057
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 168
ID: 9730
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251334
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0