CMS Formulary

Displaying 22051-22060 of 1611142 results.
ID: 22051
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 859871
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22052
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 204416
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22053
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1722934
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22054
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1807632
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22055
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1795609
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22056
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1795477
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22057
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 581531
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22058
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371050
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 22059
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371054
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 22060
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371058
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30