CMS Formulary

Displaying 22101-22110 of 1611142 results.
ID: 22101
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 309955
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22102
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1117531
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 50
Qty Limit Days: 30
ID: 22103
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1116758
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 25
Qty Limit Days: 30
ID: 22104
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 1440936
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22105
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 309077
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22106
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 313428
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22107
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 242680
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22108
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 205292
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22109
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 205290
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 22110
Formulary ID: 00021006
Formulary Version: 14
Contract Year: 2021
RXCUI: 315134
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0